Provider Demographics
NPI:1073617023
Name:ROGERS, RODMAN S (MD)
Entity Type:Individual
Prefix:DR
First Name:RODMAN
Middle Name:S
Last Name:ROGERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2186 GEARY BLVD STE 214
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3456
Mailing Address - Country:US
Mailing Address - Phone:415-922-3255
Mailing Address - Fax:415-922-2527
Practice Address - Street 1:2186 GEARY BLVD
Practice Address - Street 2:SUITE 214
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3455
Practice Address - Country:US
Practice Address - Phone:415-922-0347
Practice Address - Fax:415-922-2527
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62450208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0011420Medicaid
CAH46360Medicare UPIN
CA00A624500Medicare ID - Type Unspecified