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Roula Soufi Adjan

Pediatrics

Allopathic & Osteopathic Physicians

7695 Cardinal Ct Ste 370, San Diego, CA 92123-3332

PECOS Enrollment

This provider is enrolled in PECOS as ROULA ADJAN.

Based on the most recent information from CMS, provider Roula Soufi Adjan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 2:29 PM.

Profile Details

Provider ID
1992847263
Provider Type
Individual
Full Name
Adjan, Roula Soufi
Title
Dr.
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
2/13/2007
Last Updated
2/8/2023

Contact Information

Practice Location

7695 Cardinal Ct Ste 370, San Diego, CA 92123-3332

(619) 865-6479

Unlisted Fax

Mailing Location

10785 Calle Mar De Mariposa, San Diego, CA 92130-8656

(619) 865-6479

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208000000X Primary	Description Pediatrics Allopathic & Osteopathic Physicians	License A81682 California

Provider Identifiers

ID	Description	Issuer
ID 57888	Description Other	Issuer THE AMERICAN BOARD OF PEDIATRICS California

Roula Soufi Adjan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Vaidya, Kamala

Patel, Siri J

Ulloa, Erlinda

Martinez-Andree, Ingrid L

Jones, Kenneth Lyons

Nguyen, Vi T.

Crawford, Michael Andrew

Manriquez-Castillo, Erendira

Grobman, Lillian

Tam, Derek Chi-Fung