Organization
VANCE D. RODGERS, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIRGINIA ANN RODGERS (VICE PRESIDENT)
(805) 786-4240
Entity
Organization
Contact information
Practice address
1551 BISHOP ST, SUITE 230, SAN LUIS OBISPO, CA 93401-4635
(805) 786-4563
(805) 786-4220
Mailing address
1551 BISHOP ST, SUITE 230, SAN LUIS OBISPO, CA 93401-4635
(805) 786-4563
(805) 786-4220
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G44433
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G444330
—
CA
01
—
100017094
MEDICARE RR PIN
CA
01
—
1037
CMSP NUMBER
CA
01
—
DF9788
MEDICARE RR UPIN
CA
01
—
G44433
MEDICAL LICENSE NUMBER
CA
Enumeration date
11/02/2006
Last updated
03/07/2023
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