Provider Demographics
NPI:1932253952
Name:ROTHI, BRIAN DEAN (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:DEAN
Last Name:ROTHI
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 1:8135 PAINTER AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-3169
Mailing Address - Country:US
Mailing Address - Phone:562-698-0383
Mailing Address - Fax:562-693-6435
Practice Address - Street 1:8135 PAINTER AVE STE 300
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-3169
Practice Address - Country:US
Practice Address - Phone:562-698-0383
Practice Address - Fax:562-693-6435
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34821207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0048970Medicaid
CAA46103Medicare UPIN
CAGR0048970Medicaid