Provider Demographics
NPI:1467676353
Name:ROXAS, CZARINA J (MD)
Entity Type:Individual
Prefix:
First Name:CZARINA
Middle Name:J
Last Name:ROXAS
Suffix:
Gender:F
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:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:901 WILSHIRE BLVD FL 1
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-1854
Practice Address - Country:US
Practice Address - Phone:310-829-8441
Practice Address - Fax:424-212-5932
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA235338207P00000X
CA235338207P00000X
CAA107056207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2153394Medicaid
MA2153394Medicaid