John A Roohan, MD
Family Medicine in Santa Monica, CA. Individual provider (NPI-1).
NPI number1245274125
StatusActive
Last updated in NPPESFeb 23, 2021
Details
- NPI
- 1245274125
- Entity type
- Individual (NPI-1)
- Name
- John A Roohan
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 15, 2006
- Certification date
- Feb 23, 2021
- Last updated
- Feb 23, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - FAMILY PRACTICE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | G73104 | CA | Yes |
Practice location
2509 Pico BlvdSanta Monica, CA 90405-1828
Phone 310-392-8636 · Fax 310-392-6642
Mailing address
604 Rose AveVenice, CA 90291-2767
Phone 310-392-8636
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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