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NPI Code Detail

MEDICARE: ROGER E DER M.D.

MEDICARE: ROGER E DER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianA65753CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558355156
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROGER E DER M.D.
Provider Business Mailing Address
First Line : 300 W HUNTINGTON DR
Second Line :
City : ARCADIA
State : CA
Zip : 91007-3402
Country : US
Telephone Number : 626-574-3488
Fax Number : 626-821-6934
Provider Business Practice Location Address
First Line : 300 W HUNTINGTON DR
Second Line :
City : ARCADIA
State : CA
Zip : 91007-3402
Country : US
Telephone Number : 626-574-3488
Fax Number : 626-821-6934
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2005
Last Update Date : 03/11/2025

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Directions to “ ROGER E DER M.D.” Practice Location

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