Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gustavo Mario Roldan, PAC

Individual provider Physician Assistant · NPI 1790720381

Gustavo Mario Roldan, PAC is a Physician Assistant in South Gate, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

3221 Liberty Blvd
South Gate, CA 90280-2315
Phone: (323) 566-9171
Fax: (323) 566-9178
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA17277 (CA)

Record details

NPI number1790720381
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedJune 18, 2006
Last updated in NPPESJuly 8, 2007

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