Provider Demographics
NPI:1457516551
Name:ROGERS, MORGAN W (DC)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:W
Last Name:ROGERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3951 S PLAZA DR STE 150
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-7461
Mailing Address - Country:US
Mailing Address - Phone:714-623-3386
Mailing Address - Fax:
Practice Address - Street 1:3951 S PLAZA DR STE 150
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-7461
Practice Address - Country:US
Practice Address - Phone:714-623-3386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20370111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU27513Medicare UPIN