Roger Lee Engelbert, MD

Individual provider Active NPI Psychiatry Physician · San Pedro, CA

NPI 1447338488 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1447338488
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
License
G8443 (CA)
Practice address
150 W 7TH St
San Pedro, CA 90731-3320
Phone
(310) 519-6100
Fax
(310) 732-5809
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G8443CAMDPsychiatry Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G8443 CA Yes

Addresses

Primary practice location

150 W 7TH St
San Pedro, CA 90731-3320

Mailing address

150 W 7TH St
San Pedro, CA 90731-3320
Phone (310) 519-6100

Other providers in San Pedro, CA

All providers in San Pedro, CA · Psychiatry Physician in California

Sources for this page

Verify at the official NPI Registry.