Individual
DR. ROGER C ON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4835 VAN NUYS BLVD STE 208, SHERMAN OAKS, CA 91403-2142
(818) 946-2373
Mailing address
4215 STERN AVE, SHERMAN OAKS, CA 91423-4226
(818) 458-7572
(877) 977-7475
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G40341
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G403410
BLUE SHIELD
CA
05
—
00G403410
—
CA
Enumeration date
05/30/2005
Last updated
08/27/2020
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