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

Roth Bun Ea

Individual provider Foot & Ankle Surgery Podiatrist · NPI 1467984096

Roth Bun Ea is a Podiatry in Davis, California. Qualified in 2017, 9 years ago. Practices with Basso Podiatry Group Inc, a 5-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
9
Licensed in
CA
In the registry since
2017

Practice location Address checks out

635 Anderson Rd Ste 19
Davis, CA 95616-3505
Phone: (530) 758-1810
Fax: (530) 758-1896
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence E5893 (CA)

Record details

NPI number1467984096
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 2, 2017
Last updated in NPPESDecember 2, 2022
Certification dateDecember 2, 2022
Mailing address635 Anderson Rd Ste 19, Davis, CA 95616-3505

Medicare enrollment

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

Medicare specialtyPODIATRY
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Basso Podiatry Group Inc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Davis