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GUSTAVO MARIO ROLDAN PAC
NPI 1790720381
Physician Assistant in South Gate, CA

Active since June 18, 2006
3221 LIBERTY BLVD, SOUTH GATE, CA 90280(323) 566-9171(323) 566-9178 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Gustavo Mario Roldan Pac NPPES

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

GUSTAVO MARIO ROLDAN PAC (NPI 1790720381) is an individual physician assistant in South Gate, California, licensed in California (PA17277) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1790720381
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameGUSTAVO MARIO ROLDANCredential: PAC
Location Address3221 LIBERTY BLVDSouth Gate, CA 90280-2315
Mailing Address3221 Liberty BlvdSouth Gate, CA 90280-2315 · (323) 566-9171 · Fax (323) 566-9178
Phone(323) 566-9171
Fax(323) 566-9178
Sole ProprietorNo
Enumeration DateJune 18, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1790720381 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · PA17277
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
3221 LIBERTY BLVD, South Gate, CA 90280
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Other Providers at the Same Location NPPES 3

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

CLINICA SAN MARCOS MEDICAL CENTER APC
General Practice
3221 LIBERTY BLVD
SOUTH GATE, CA 90280
Los Angeles County (323) 566-9171
CLINICA MEDICA SAN MARCOS, INC
Clinic/Center (Primary Care)
3221 LIBERTY BLVD
SOUTH GATE, CA 90280
Los Angeles County (323) 566-9171
CLINICA MEDICA SAN MARCOS INC
General Practice
3221 LIBERTY BLVD
SOUTH GATE, CA 90280
Los Angeles County (323) 566-9171

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 Gustavo Roldan's NPI number?

The NPI number for Gustavo Roldan is 1790720381. It was assigned to this individual provider in the NPPES registry on June 18, 2006.

Where is Gustavo Roldan located?

Gustavo Roldan practices at 3221 Liberty Blvd, South Gate, CA 90280. The listed phone number is (323) 566-9171.

What is Gustavo Roldan's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Gustavo Roldan was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.