Dr. Kenneth Raymond Roth , MD
Specialist • Poway, CA
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Kenneth Roth has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Kenneth Roth, MD was a registered Specialist practicing in Poway, CA. Throughout an active medical career spanning 13 years, Dr. Roth provided care at the practice location at 13636 JACK RABBIT RD until profile deactivation on 2019-04-29.
Practice Location & Contact Primary Location
13636 Jack Rabbit Rd
Poway, CA 920641702
Specialty Benchmarks & Practice Insights
Comparative analytics for Specialist in Poway, CA
Practicing in Poway, CA (6446 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 174400000X
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on April 29, 2019
NPI status registered as active in NPPES database
Registered at 13636 JACK RABBIT RD, POWAY, CA 920641702 (Tel: 8588421246)
Registered at PO BOX 501173, SAN DIEGO, CA 921501173 (Tel: 8588421246)
Recorded as KENNETH ROTH, M.D.
Specialist (License #G10668 in CA)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
Po Box 501173
San Diego, CA 921501173
Phone: 8588421246
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