Provider Demographics
NPI:1891716494
Name:ROJTER, SERGIO E (MD)
Entity Type:Individual
Prefix:MR
First Name:SERGIO
Middle Name:E
Last Name:ROJTER
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 1:1245 WILSHIRE BLVD STE 770
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-4881
Mailing Address - Country:US
Mailing Address - Phone:310-914-9150
Mailing Address - Fax:310-914-9705
Practice Address - Street 1:1245 WILSHIRE BLVD STE 770
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-4881
Practice Address - Country:US
Practice Address - Phone:310-250-3344
Practice Address - Fax:310-297-4477
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63254207RI0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A632540Medicaid
CAW16863Medicare ID - Type Unspecified
CA00A632540Medicaid