# PETER A VON ROGOV MDA PROFESSIONAL CORPORATION

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

## Provider details

- **NPI number:** 1720265937
- **Authorized official:** PETER A VON ROGOV MD (PRESIDENT)
- **Authorized official phone:** (415) 749-5743

## Contact information

- **Practice address:** 2100 WEBSTER ST STE 300, SAN FRANCISCO, CA 94115
- **Practice address phone:** (415) 749-5743
- **Practice address fax:** (415) 673-4971
- **Mailing address:** 2100 WEBSTER ST STE 300, SAN FRANCISCO, CA 94115
- **Mailing address phone:** (415) 749-5743
- **Mailing address fax:** (415) 673-4971

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | A23061 | CA | Yes |

## Other

- **Enumeration date:** 01/30/2008
- **Last updated:** 10/23/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GR0014400 | — | CA |