MEDICARE: ROGER S ENG MD

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
1	2085R0202X	Diagnostic Radiology Physician	G75471	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871607291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROGER S ENG MD

Provider Business Mailing Address
First Line	:	PO BOX 26750
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93729-6750
Country	:	US
Telephone Number	:	559-455-4053
Fax Number	:	770-666-9102

Provider Business Practice Location Address
First Line	:	845 JACKSON ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94133-4851
Country	:	US
Telephone Number	:	415-677-2320
Fax Number	:	770-666-9102

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	05/03/2012

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Directions to “ ROGER S ENG MD” Practice Location

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