Organization
ROGER ROGALSKI MD CHTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER PAUL ROGALSKI MD (PRES SEC ETC)
(775) 841-9991
Entity
Organization
Contact information
Practice address
2169 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150-7059
(530) 544-1513
(530) 544-2359
Mailing address
2874 N CARSON ST, #105, CARSON CITY, NV 89706-0177
(775) 841-9991
(775) 841-9485
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
6391
NV
207X00000X
Orthopaedic Surgery Physician
Primary
G71822
CA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
6391
NV
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
G71822
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G718220
CALIF MEDI-CAL ID
CA
Enumeration date
06/15/2006
Last updated
01/04/2008
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