Provider Demographics
NPI:1487637351
Name:ROXAS, ARNOLD GIDAYA (DPM)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:GIDAYA
Last Name:ROXAS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501
Mailing Address - Country:US
Mailing Address - Phone:310-373-7855
Mailing Address - Fax:424-704-2493
Practice Address - Street 1:1727 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501
Practice Address - Country:US
Practice Address - Phone:310-373-7855
Practice Address - Fax:424-704-2493
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-23
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3995213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE3995Medicaid
CA000E39951Medicaid
CA000E39950Medicaid
CAE3995Medicare ID - Type Unspecified
CAWE3995DMedicare ID - Type Unspecified