| Rogece A Professional Medical Corporation | |
|
18433 Roscoe Blvd Suite 103 Northridge CA 91325-4108 | |
| (818) 734-7620 | |
| (818) 734-7621 |
| Full Name | Rogece A Professional Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 18433 Roscoe Blvd, Northridge, California |
| Authorized Official Name and Position | Cesar A. Vega (DIRECTOR) |
| Authorized Official Contact | 8187347620 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rogece A Professional Medical Corporation 18433 Roscoe Blvd Suite 103 Northridge CA 91325-4108 Ph: (818) 734-7620 | Rogece A Professional Medical Corporation 18433 Roscoe Blvd Suite 103 Northridge CA 91325-4108 Ph: (818) 734-7620 |
| NPI Number | 1194837518 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1153335310 |
|---|---|
| Medicare Enrollment ID | O20060126001058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194837518 | NPI | - | NPPES |
| 0A767910 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A76791 (California) | Primary |
| Provider Name | Cesar A Vega |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093736548 PECOS PAC ID: 8325052582 Enrollment ID: I20060127000390 |
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