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General NPI Number Information
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NPI Number | 1831212075
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Entity Type | Individual
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Provider Name | BRYAN MICHAEL ROGOFF OD, MBA, MSC,
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 6754 BERNAL AVE STE 740-204
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City | PLEASANTON
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State | CA
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Zip | 94566-1232
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Country | US
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Telephone | 877-423-3932
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Fax |
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Provider Business Mailing Address
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Address Line | 6754 BERNAL AVE STE 740-204
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City | PLEASANTON
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State | CA
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Zip | 94566-1232
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OP833
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA1645
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046-009321
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT35348
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License Number State | CA
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