Healthcare Provider Details

I. General information

NPI: 1073617023
Provider Name (Legal Business Name): RODMAN S ROGERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 02/18/2020
Certification Date: 02/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2186 GEARY BLVD SUITE 214
SAN FRANCISCO CA
94115-3455
US

IV. Provider business mailing address

2186 GEARY BLVD STE 214
SAN FRANCISCO CA
94115-3456
US

V. Phone/Fax

Practice location:
  • Phone: 415-922-0347
  • Fax: 415-922-2527
Mailing address:
  • Phone: 415-922-3255
  • Fax: 415-922-2527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberA62450
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: