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Ethan Roberts
NPI 1497193585 · on the registry since 2013 · sole proprietor
Practice
- Address
- 722 Norvell St
El Cerrito, CA 94530 - Phone
- (510) 647-9836
Registry record
- Primary taxonomy
- 390200000X
390200000X
- Licence states on file
- NULL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-02-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California