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NPI Code Detail

MEDICARE: DR. PATRICK BRENDAN ROGERS D.C.

MEDICARE: DR. PATRICK BRENDAN ROGERS D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor18936CA

General Provider Information

NPI Number : 1790710515
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICK BRENDAN ROGERS D.C.
Provider Business Mailing Address
First Line : PO BOX 531
Second Line :
City : BOULDER CREEK
State : CA
Zip : 95006-0531
Country : US
Telephone Number : 831-338-2555
Fax Number : 831-338-3004
Provider Business Practice Location Address
First Line : 13266 HIGHWAY 9
Second Line : SUITE A
City : BOULDER CREEK
State : CA
Zip : 95006-8913
Country : US
Telephone Number : 831-338-2555
Fax Number : 831-338-3004
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 07/08/2007

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