Provider Demographics
NPI:1376721456
Name:BRIAN C ROGERS, MD, INC
Entity Type:Organization
Organization Name:BRIAN C ROGERS, MD, INC
Other - Org Name:BRIAN C ROGERS, MD, INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, INC
Authorized Official - Phone:714-992-4444
Mailing Address - Street 1:PO BOX 4030
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92834-4030
Mailing Address - Country:US
Mailing Address - Phone:714-992-4444
Mailing Address - Fax:714-879-9999
Practice Address - Street 1:361 HOSPITAL RD
Practice Address - Street 2:SUITE 124
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3522
Practice Address - Country:US
Practice Address - Phone:949-631-0988
Practice Address - Fax:949-631-2504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG30212207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty