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General NPI Number Information
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NPI Number | 1932460615
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Entity Type | Individual
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Provider Name | DARYL PAUL ROGERS
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Gender | Male
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 541 S HAM LN STE A
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City | LODI
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State | CA
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Zip | 95242-3530
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Country | US
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Telephone | 209-333-2020
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Fax | 209-333-1188
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Provider Business Mailing Address
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Address Line | 541 S HAM LN STE A
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City | LODI
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State | CA
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Zip | 95242-3530
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Country | US
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Telephone | 209-333-2020
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Fax | 209-333-1188
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HA2996
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number | SL4692
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | SL4692
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License Number State | CA
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