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

Justin Roldan

Individual provider Certified Registered Nurse Anesthetist · NPI 1922363993

Justin Roldan is a Certified Registered Nurse Anesthetist (CRNA) in Harbor City, California. Qualified in 2012, 14 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
14
Licensed in
CA
In the registry since
2012
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Practice location Address checks out

25825 Vermont Ave
Harbor City, CA 90710-3518
Phone: (310) 325-5111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 4264 (CA)

Record details

NPI number1922363993
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 5, 2012
Last updated in NPPESNovember 19, 2021
Certification dateNovember 19, 2021
Mailing address25825 Vermont Ave, Harbor City, CA 90710-3518

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Harbor City