SEAN K ROH MD
NPI 1104568922
Student in an Organized Health Care Education/Training Program in Fontana, CA

Active since April 12, 2022PECOS EnrolledAccepts Medicare Assignment
17234 VALLEY BLVD, BLDG. A, FONTANA, CA 92335(909) 427-2608 Get Directions Write a Review

NPPES record last updated: July 27, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 27, 2022, Apr 12, 2022 (2 updates tracked since 2022).

About Sean K Roh Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SEAN K ROH MD (NPI 1104568922) is an individual student in an organized health care education/training program in Fontana, California and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS and is a graduate of Cooper Medical School Of Rowan University (2022).

NPPES Registry Identity

NPI1104568922
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSEAN K ROHCredential: MD
Location Address17234 VALLEY BLVD, BLDG. AFontana, CA 92335
Mailing Address17234 Valley Blvd, Bldg. AFontana, CA 92335
Sole ProprietorNo
Medical School CMSCooper Medical School Of Rowan UniversityGraduated 2022
Enumeration DateApril 12, 2022
Last NPPES UpdateJuly 27, 20222 updates tracked since enumeration
NPPES CertifiedMarch 27, 2022
NPI 1104568922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
17234 VALLEY BLVD, Fontana, CA 92335

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Sean K Roh Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4385081884
PECOS Enrollment IDI20241126003618
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD
FONTANA, CA 92335
Psychiatry & Neurology (Psychiatry)
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
Family Medicine
17234 VALLEY BLVD
FONTANA, CA 92335
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD
FONTANA, CA 92335
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sean Roh's NPI number?

The NPI number for Sean Roh is 1104568922. It was assigned to this individual provider in the NPPES registry on April 12, 2022.

Where is Sean Roh located?

Sean Roh practices at 17234 Valley Blvd Bldg. A, Fontana, CA 92335. The listed phone number is (909) 427-2608.

What is Sean Roh's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Sean Roh enrolled in Medicare?

Yes. Sean Roh is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Sean Roh was last updated on July 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.