Roger D. Duber D.O., Inc.

Primary specialty

ContractorTaxonomy code 171W00000X

License

20A4904 Issued in CA

Legal business name

ROGER D. DUBER D.O., INC.

Practice address

685 N 13TH Ave
Suite 9
Upland, CA 91786-4916

Phone

(909) 981-8383

Fax

(909) 920-3054

NPI assigned

May 18, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Roger D Duber, D.O.

Title

Owner

Phone

(909) 981-8383

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ROGER D. DUBER D.O., INC. Former legal business name

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/f2d842ce-493a-4093-99fd-17ce5bfafb71/

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1245448752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 N 13TH AVE",
            "address_2": "SUITE 9",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864916",
            "telephone_number": "909-981-8383",
            "fax_number": "909-920-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 N 13TH AVE",
            "address_2": "SUITE 9",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864916",
            "telephone_number": "909-981-8383",
            "fax_number": "909-920-3054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER D. DUBER D.O., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "DUBER",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-981-8383",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Contractor",
            "state": "CA",
            "license": "20A4904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX49040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROGER D. DUBER D.O., INC.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jessica Marlene Rodriguez
• Josue Rodriguez
• Marina Joan Rodriguez
• Renee Rodriguez
• Richmond Emmerson Roeske, M.D.
• Kayla Rogers
• Jasmine Jessica Rojas Gonzalez
• Esteban Rojas Jr.
• Sadie Rojas, LMFT
• Mayra Roman Hernandez, FNP-C

• Contractor in Upland, CA
• Providers in Upland, CA by specialty
• Contractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.