Provider Demographics
NPI:1073861522
Name:ROACHE, JAMES HAROLD (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:HAROLD
Last Name:ROACHE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26611 CABOT ROAD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-7018
Mailing Address - Country:US
Mailing Address - Phone:949-348-7900
Mailing Address - Fax:949-348-7920
Practice Address - Street 1:26611 CABOT ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7018
Practice Address - Country:US
Practice Address - Phone:949-348-7900
Practice Address - Fax:949-348-7920
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH26593183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist