Healthcare Provider Details

I. General information

NPI: 1306578414
Provider Name (Legal Business Name): ZETH THOMAS ROGERS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 FORTUNE CT
AUBURN CA
95602-7847
US

IV. Provider business mailing address

2203 PLAZA DR STE 110
ROCKLIN CA
95765-4427
US

V. Phone/Fax

Practice location:
  • Phone: 916-938-2532
  • Fax: 877-569-2252
Mailing address:
  • Phone: 916-938-2531
  • Fax: 877-569-2252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number61753
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: