MEDICARE: DR. ROGER STEVEN VARGAS 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
1	207Q00000X	Family Medicine Physician	G078140	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1831112051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROGER STEVEN VARGAS M.D.

Provider Business Mailing Address
First Line	:	1310 PRENTICE DR
Second Line	:	SUITE E
City	:	HEALDSBURG
State	:	CA
Zip	:	95448-3384
Country	:	US
Telephone Number	:	707-433-5511
Fax Number	:

Provider Business Practice Location Address
First Line	:	1310 PRENTICE DR
Second Line	:	SUITE E
City	:	HEALDSBURG
State	:	CA
Zip	:	95448-3384
Country	:	US
Telephone Number	:	707-433-5511
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/09/2007

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