Provider Demographics
NPI:1477633626
Name:ROUM, JAMES HENRY (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:HENRY
Last Name:ROUM
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 1:1010 W LA VETA AVE STE 750
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4312
Mailing Address - Country:US
Mailing Address - Phone:714-639-9401
Mailing Address - Fax:714-919-8804
Practice Address - Street 1:1010 W LA VETA AVE STE 750
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4312
Practice Address - Country:US
Practice Address - Phone:714-639-9401
Practice Address - Fax:714-919-8804
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG62370207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1912919804Medicaid
CAG62370OtherMEDICAL LICENSE
CAP00703134OtherRAIL ROAD MEMBER PTAN
CA1912919804OtherTYPE 2 NPI
CACG5665OtherRAIL ROAD GROUP PTAN
CAP00703134OtherRAIL ROAD MEMBER PTAN
CA1912919804OtherTYPE 2 NPI