Edward G. Rohaly,M.D. Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

G62009 Issued in CA

Legal business name

EDWARD G. ROHALY,M.D. INC.

Practice address

360 San Miguel Dr
Suite 309
Newport Beach, CA 92660-7829

Phone

(949) 640-0434

Fax

(949) 640-0277

NPI assigned

Nov 17, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Edward George Rohaly, M.D.

Title

President

Phone

(949) 640-0434

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289952000000",
    "number": "1700188174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 SAN MIGUEL DR",
            "address_2": "SUITE 309",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607829",
            "telephone_number": "949-640-0434",
            "fax_number": "949-640-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 SAN MIGUEL DR",
            "address_2": "SUITE 309",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607829",
            "telephone_number": "949-640-0434",
            "fax_number": "949-640-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD G. ROHALY,M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-17",
        "last_updated": "2010-11-17",
        "status": "A",
        "authorized_official_last_name": "ROHALY",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-640-0434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "G62009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.