Provider Demographics
NPI:1649449448
Name:ROH, EUGENE YOUSIK (MD)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:YOUSIK
Last Name:ROH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EUGENE
Other - Middle Name:
Other - Last Name:ROH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:300 PASTEUR DR # MC6342
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:650-723-4000
Mailing Address - Fax:
Practice Address - Street 1:450 BROADWAY ST FL C4
Practice Address - Street 2:MC6342
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-3132
Practice Address - Country:US
Practice Address - Phone:650-721-7627
Practice Address - Fax:650-721-3470
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97398208100000X, 2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation