Jae Ho Roh
Individual provider Active NPI Chiropractor · Sunnyvale, CA
NPI 1841965795 · NPPES record last updated Mar 5, 2024
Key facts
- NPI
- 1841965795
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 35085 (CA)
- Practice address
- 333 Cobalt Way Ste 101
Sunnyvale, CA 94085-5404 - Phone
- (408) 761-4312
- NPI assigned
- Aug 12, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35085 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revive Chiropractic, Roh Inc. | Chiropractor | Current |
Accepting new patients |
| New Hope Chiropractic, Inc. | Chiropractor | Past |
Accepting new patients |
Locations
333 Cobalt Way
Ste 101
Sunnyvale, CA 94085
Phone (408) 212-4711
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 35085 | CA | Yes |
Addresses
Primary practice location
333 Cobalt Way Ste 101
Sunnyvale, CA 94085-5404
Mailing address
731 Ormonde Dr
Mountain View, CA 94043-3114
Phone (408) 761-4312
Other providers in Sunnyvale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.