Provider Demographics
NPI:1861417172
Name:ROJAS, CARLOS J (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:J
Last Name:ROJAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 LEWIS ST
Mailing Address - Street 2:MAIL CODE 9201-A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2108
Mailing Address - Country:US
Mailing Address - Phone:619-471-9291
Mailing Address - Fax:
Practice Address - Street 1:330 LEWIS ST
Practice Address - Street 2:MAIL CODE 9201-A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2108
Practice Address - Country:US
Practice Address - Phone:619-471-9291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40006207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A400060Medicaid
CA00A400060Medicaid
CAWA40006EMedicare UPIN