Provider Demographics
NPI:1184736274
Name:ROJO, JOSEPH ESSEX (PAC)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ESSEX
Last Name:ROJO
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1054 CAMINO DEL CERRITOS
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-4466
Mailing Address - Country:US
Mailing Address - Phone:626-806-0890
Mailing Address - Fax:
Practice Address - Street 1:1626 W TEMPLE ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-5027
Practice Address - Country:US
Practice Address - Phone:213-353-0610
Practice Address - Fax:213-353-4802
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA15905363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00021066OtherRAILROAD MEDICARE
P82964Medicare UPIN
CAWPA15905EMedicare ID - Type Unspecified
CAP00021066OtherRAILROAD MEDICARE
CAWPA15905BMedicare ID - Type Unspecified
CAWPA15905HMedicare ID - Type Unspecified