Roger John Cabansag, M.D.
Individual provider Active NPI Psychiatry Physician · Patton, CA
NPI 1063464352 · NPPES record last updated Sep 24, 2013
Key facts
- NPI
- 1063464352
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- A70834 (CA)
- Practice address
- 3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369 - Phone
- (909) 425-7679
- Fax
- (909) 425-6635
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050429000724 | CA | Practitioner - Psychiatry | 0143269068 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A70834 | CA | MD | Psychiatry Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A70834 | CA | Yes |
Addresses
Primary practice location
3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369
Mailing address
3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369
Phone (909) 425-7679
Other providers in Patton, CA
- William Gordon Britt III
- Robert Edward Brodie
- Felicia Ann Brown
- Hong (Rose) Bui
- Melanie Ann Byde
- Cintia Clementina Caldera Cuevas
- Robin Campbell
- Elba I Campos
- Lorna Carlin
- Edward P Case
All providers in Patton, CA · Psychiatry Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.