# ROGER ROGALSKI MD CHTD

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437193869
- **Authorized official:** ROGER PAUL ROGALSKI MD (PRES SEC ETC)
- **Authorized official phone:** (775) 841-9991

## Contact information

- **Practice address:** 2169 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150-7059
- **Practice address phone:** (530) 544-1513
- **Practice address fax:** (530) 544-2359
- **Mailing address:** 2874 N CARSON ST, \#105, CARSON CITY, NV 89706-0177
- **Mailing address phone:** (775) 841-9991
- **Mailing address fax:** (775) 841-9485

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 6391 | NV | — |
| 207X00000X | Orthopaedic Surgery Physician | G71822 | CA | Yes |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | 6391 | NV | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | G71822 | CA | — |

## Other

- **Enumeration date:** 06/15/2006
- **Last updated:** 01/04/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00G718220 | CALIF MEDI-CAL ID | CA |