Provider Demographics
NPI:1669556361
Name:ROLAND, AARON MELLOR (MD)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:MELLOR
Last Name:ROLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1720 EL CAMINO REAL
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3224
Mailing Address - Country:US
Mailing Address - Phone:650-692-0977
Mailing Address - Fax:650-259-5840
Practice Address - Street 1:1720 EL CAMINO REAL
Practice Address - Street 2:SUITE 130
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3224
Practice Address - Country:US
Practice Address - Phone:650-692-0977
Practice Address - Fax:650-259-5840
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2009-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG065645207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G656450Medicare PIN
CAF15277Medicare UPIN