Provider Demographics
NPI:1497058424
Name:DAVID E. ROGERS, M.D. A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DAVID E. ROGERS, M.D. A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-243-0499
Mailing Address - Street 1:222 WEST EULALIA STREET
Mailing Address - Street 2:SUITE 309
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2843
Mailing Address - Country:US
Mailing Address - Phone:818-243-0499
Mailing Address - Fax:818-243-0280
Practice Address - Street 1:222 WEST EULALIA STREET
Practice Address - Street 2:SUITE 309
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2843
Practice Address - Country:US
Practice Address - Phone:818-243-0499
Practice Address - Fax:818-243-0280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-14
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty