Provider Demographics
NPI:1962543090
Name:ROGERS, PAUL FRANK (CRNFA)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:FRANK
Last Name:ROGERS
Suffix:
Gender:M
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3055 N VALLEYVIEW ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-1722
Mailing Address - Country:US
Mailing Address - Phone:714-305-4851
Mailing Address - Fax:
Practice Address - Street 1:3055 N VALLEYVIEW ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-1722
Practice Address - Country:US
Practice Address - Phone:714-305-4851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA410874163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant