Provider Demographics
NPI:1811968530
Name:ORMAN, RODGER STUART (MD)
Entity type:Individual
Prefix:DR
First Name:RODGER
Middle Name:STUART
Last Name:ORMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34120
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89533-4120
Mailing Address - Country:US
Mailing Address - Phone:775-747-5050
Mailing Address - Fax:775-747-5005
Practice Address - Street 1:700 MOUNTAIN RANCH RD STE C-1
Practice Address - Street 2:
Practice Address - City:SAN ANDREAS
Practice Address - State:CA
Practice Address - Zip Code:95249-9707
Practice Address - Country:US
Practice Address - Phone:209-754-4334
Practice Address - Fax:209-754-3026
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52961207LP2900X, 207PE0004X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G529610OtherBLUE SHIELD
CA94-3381010OtherBLUE CROSS
CAZZZ01476ZOtherBLUE SHIELD
CA94-3381010OtherBLUE CROSS
CAA52399Medicare UPIN
CAZZZ01476ZOtherBLUE SHIELD