Provider Demographics
NPI:1417045709
Name:HEILMAN, ROGER HARVEY (MD)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:HARVEY
Last Name:HEILMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3535 LOMBARDY RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-5628
Mailing Address - Country:US
Mailing Address - Phone:626-793-2302
Mailing Address - Fax:626-304-1014
Practice Address - Street 1:550 S VERMONT AVE
Practice Address - Street 2:704B
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1912
Practice Address - Country:US
Practice Address - Phone:213-739-7309
Practice Address - Fax:213-351-2024
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG166602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry