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General NPI Number Information
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NPI Number | 1023308145
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Entity Type | Organization
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Legal Business Name | NICHOLAS A ROGERS MD INC
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 12/28/2011
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Provider Practice Location Address
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Address Line | 1414 S GRAND AVE STE 383 SUITE 383
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City | LOS ANGELES
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State | CA
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Zip | 90015-3072
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Country | US
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Telephone | 213-741-1440
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Fax | 213-741-1464
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Provider Business Mailing Address
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Address Line | 1414 S GRAND AVE STE 383 SUITE 383
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City | LOS ANGELES
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State | CA
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Zip | 90015-3072
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Country | US
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Telephone | 213-741-1440
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Fax | 213-741-1464
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICHOLAS A ROGERS
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Credential | M.D.
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Telephone | 213-741-1440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A112189
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License Number State | CA
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