G & J ROTH PROFESSIONAL CORP (NPI# 1275675480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275675480 |
| Entity Type | Organization |
| Organization Name | G & J ROTH PROFESSIONAL CORP |
| Other Organization Name | TIMOTHY J. ROTH, DO |
| Practice Address |
255 W Bullard Ave 102 Clovis CA 93612-0861 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 5592992128 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2012-10-17 |
| Authorized Official Name | KENNY HEINE (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 8586252990 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 20A5200 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Timothy J. Roth, DO | Doing Business As Name - Organization |
| Street Address |
255 W BULLARD AVE 102 |
| City | CLOVIS |
| State | CA |
| Zip Code | 93612-0861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255330809 | Rustom F Damania | Internal Medicine | 255 W Bullard Ave, 113, Clovis, CA 93612-0861 | 2005-07-17 |
| 1235670787 | Central Valley Indian Health, Inc. | Clinic/Center | 255 W Bullard Ave, Suite 109, Clovis, CA 93612-0861 | 2017-03-16 |
| 1104360213 | Julian Alphonse Harris | Physical Therapist | 255 W Bullard Ave, 114, Clovis, CA 93612-0861 | 2016-12-08 |
| 1316327844 | Rochelle Smith | Marriage & Family Therapist | 255 W Bullard Ave, Clovis, CA 93612-0861 | 2015-05-29 |
| 1477893998 | Taban Bazrafshan | Dietitian, Registered | 255 W Bullard Ave, Suite 124, Clovis, CA 93612-0861 | 2013-02-20 |
| 1952664096 | Kimberly Trejo | Social Worker | 255 W Bullard Ave, Suite 124, Clovis, CA 93612-0861 | 2012-06-22 |
| 1376854943 | Gurmit Singh Deol | Registered Nurse | 255 W Bullard Ave, Suite 124, Clovis, CA 93612-0861 | 2010-06-28 |
| 1295971638 | Steven Joseph Thuringer | Physical Medicine & Rehabilitation | 255 W Bullard Ave, Suite 114, Clovis, CA 93612-0861 | 2009-01-06 |
| 1922208404 | Harjeet K Dhaliwal | Internal Medicine | 255 W Bullard Ave, Suite 124, Clovis, CA 93612-0861 | 2007-07-23 |
| 1679784540 | Cheryl Leighter | Dietitian, Registered | 255 W Bullard Ave, #124, Clovis, CA 93612-0861 | 2007-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235778002 | Prieto Dental Corporation | Dentist | 2320 Clovis Avenue, Suite 102, Clovis, CA 93612 | 2019-12-27 |
| 1285190827 | Natividad Casillas | Behavior Technician | 20 N Dewitt, Clovis, CA 93612 | 2019-02-19 |
| 1922578988 | Benjamin Harold Davis Jr. | Behavior Technician | Swans Consulting, 20 N Dewitt Ave, Clovis, CA 93612 | 2018-12-03 |
| 1134620651 | Innovative Development & Living Solutions of California | Assisted Living Facility | 32 West Sierra Ave, Clovis, CA 93612 | 2018-02-21 |
| 1427578616 | Mariamajane Sengsiri | Licensed Vocational Nurse | 1244 Estabrook Ave., Clovis, CA 93612 | 2017-06-20 |
| 1417482464 | Tiffanie Guy | Pharmacist | 2810 Willow Ave Apt 206, Clovis, CA 93612 | 2017-04-27 |
| 1194271833 | Daniel Salinas | Specialist/Technologist | 1712 Harvard Ave., Clovis, CA 93612 | 2016-09-01 |
| 1386071447 | Darra Hirsh | Psychologist | 334 Shaw Ave Ste 100, Clovis, CA 93612 | 2013-10-03 |
| 1437400793 | Bashful Elephant | Counselor | 3097 Willow Suite 4, Clovis, CA 93612 | 2012-09-27 |
| 1588930432 | Nghiem Gia Vu | Pharmacist | 695 W Herdn Ave, Clovis, CA 93612 | 2012-03-26 |
| Find all providers in zip 93612 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619046950 | Clovis Family Healthcare Center LLC | Non-Pharmacy Dispensing Site | 2301 N Martin Luther King Blvd, Clovis, NM 88101 | 2006-11-08 |
| 1760725758 | Mark Godiksen | Non-Pharmacy Dispensing Site | 688 Medical Center Dr E, Suite 106, Clovis, CA 93611-6807 | 2013-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982225496 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 5757 Pacific Ave Ste 228, Stockton, CA 95207-5159 | 2020-05-06 |
| 1285268391 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 1337 S Lovers Ln Ste D, Visalia, CA 93292-5249 | 2020-02-27 |
| 1790327732 | Triumph Specialties LLC | Non-Pharmacy Dispensing Site | 11100 Sepulveda Blvd # 8-519, Mission Hills, CA 91345-1131 | 2019-10-10 |
| 1487210365 | Artius Dermatology Associates P.C. | Non-Pharmacy Dispensing Site | 325 Mall Dr Ste 111, Hanford, CA 93230-5950 | 2019-05-15 |
| 1376030080 | Jane F Kardashian Md Inc | Non-Pharmacy Dispensing Site | 6769 N Fresno, Fresno, CA 93710 | 2018-04-18 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1043719206 | Southern California Orthopedic Institute L.p | Non-Pharmacy Dispensing Site | 4100 Empire Dr Ste 120, Bakersfield, CA 93309-0408 | 2018-02-02 |
| 1174032353 | Golden Gate Urology, Inc. | Non-Pharmacy Dispensing Site | 139 Townsend St Ste 100, San Francisco, CA 94107-1946 | 2017-09-20 |
| 1215462080 | Mas Management Group, Inc. | Non-Pharmacy Dispensing Site | 28446 Constellation Rd, Valencia, CA 91355-5081 | 2017-04-28 |
| 1730624719 | St. John's Well Child and Family Center Inc | Non-Pharmacy Dispensing Site | 326 W 23rd St, Los Angeles, CA 90007-2612 | 2016-12-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.