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General NPI Number Information
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NPI Number | 1104970953
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Entity Type | Organization
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Legal Business Name | METRO MEDICAL ASSOCIATES, INC.
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 745 S STATE HIGHWAY 65 STE 20 PMB 216
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City | LINCOLN
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State | CA
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Zip | 95648-9334
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Country | US
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Telephone | 916-295-4159
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Fax |
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Provider Business Mailing Address
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Address Line | 745 S STATE HIGHWAY 65 STE 20 PMB 216
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City | LINCOLN
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State | CA
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Zip | 95648-9334
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Country | US
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Telephone | 916-295-4159
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HUNG YU ROGERS
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Credential | M.D.
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Telephone | 916-295-4159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | G78963
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License Number State | CA
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