| Vance D. Rodgers, M.d., Inc. | |
|
1551 Bishop St Suite 230 San Luis Obispo CA 93401-4635 | |
| (805) 786-4563 | |
| (805) 786-4220 |
| Full Name | Vance D. Rodgers, M.d., Inc. |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 1551 Bishop St, San Luis Obispo, California |
| Authorized Official Name and Position | Virginia Ann Rodgers (VICE PRESIDENT) |
| Authorized Official Contact | 8057864240 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vance D. Rodgers, M.d., Inc. 1551 Bishop St Suite 230 San Luis Obispo CA 93401-4635 Ph: (805) 786-4563 | Vance D. Rodgers, M.d., Inc. 1551 Bishop St Suite 230 San Luis Obispo CA 93401-4635 Ph: (805) 786-4563 |
| NPI Number | 1669551636 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669551636 | NPI | - | NPPES |
| 1037 | Other | CA | CMSP NUMBER |
| 00G444330 | Medicaid | CA | |
| DF9788 | Other | CA | MEDICARE RR UPIN |
| 100017094 | Other | CA | MEDICARE RR PIN |
| G44433 | Other | CA | MEDICAL LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | G44433 (California) | Primary |
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