MEDICARE: ROGER W WASHINGTON M D INC

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	G52316	CA

General Provider Information

NPI Number	:	1881712560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROGER W WASHINGTON M D INC

Provider Business Mailing Address
First Line	:	360 S MARKET ST UNIT 1501
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95113-2869
Country	:	US
Telephone Number	:	408-246-9926
Fax Number	:	408-246-7877

Provider Business Practice Location Address
First Line	:	2365 QUIMBY RD STE 160
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95122-1337
Country	:	US
Telephone Number	:	408-246-9926
Fax Number	:	408-246-7877

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROGER W WASHINGTON
Credential	:	M.D.
Telephone Number	:	408-246-9926

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	11/24/2025

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