Mortimer, Roger Bruce

Mortimer, Roger Bruce is an individual health care provider with primary practice located at 290 N Wayte Ln , Fresno CA 93701-2124. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Mortimer, Roger Bruce can be contacted via phone (866) 342-6012.

Contact Information

Primary practice address
290 N Wayte Ln Fresno CA 93701-2124
Phone: (866) 342-6012
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A51178 California
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207QH0002X A51178 California

Profile Details

NPI number 1871601468
LBN Legal business name Mortimer, Roger Bruce
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2006
Last updated Jan 15th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871601468 NPPES
California MEDICAID 00A511780

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