Provider Demographics
NPI:1023453131
Name:ROGONG, RASMIA C (RN)
Entity type:Individual
Prefix:
First Name:RASMIA
Middle Name:C
Last Name:ROGONG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 BRETT PL
Mailing Address - Street 2:UNIT 345
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-5088
Mailing Address - Country:US
Mailing Address - Phone:310-462-4942
Mailing Address - Fax:
Practice Address - Street 1:1414 BRETT PL
Practice Address - Street 2:UNIT 345
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90732-5088
Practice Address - Country:US
Practice Address - Phone:310-462-4942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA599518163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse