Provider Demographics
NPI:1699890905
Name:SIERRA RURAL PHYSICIANS, INC.
Entity type:Organization
Organization Name:SIERRA RURAL PHYSICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E C
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-440-3949
Mailing Address - Street 1:1048 UNION ST
Mailing Address - Street 2:#4
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-2568
Mailing Address - Country:US
Mailing Address - Phone:415-440-3949
Mailing Address - Fax:415-474-4054
Practice Address - Street 1:5189 HOSPITAL RD
Practice Address - Street 2:JOHN C. FREMONT HEALTHCARE DISTRICT
Practice Address - City:MARIPOSA
Practice Address - State:CA
Practice Address - Zip Code:95338-9524
Practice Address - Country:US
Practice Address - Phone:209-966-3631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63276207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty