Roger Bertoldi MD Professional Corporation

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

License

A40519 Issued in CA

Legal business name

ROGER BERTOLDI MD PROFESSIONAL CORPORATION

Practice address

8610 S. Sepulveda Blvd.
Los Angeles, CA 90045

Phone

(310) 670-5555

Fax

(310) 670-9222

NPI assigned

May 11, 2010

Last updated

Mar 19, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Roger V Bertoldi, MD

Title

Physician/Owner

Phone

(310) 670-5555

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426723200000",
    "number": "1952629263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8610 S. SEPULVEDA BLVD.",
            "address_2": "SUITE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90045",
            "telephone_number": "310-670-5555",
            "fax_number": "310-670-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8610 S. SEPULVEDA BLVD.",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90045",
            "telephone_number": "310-670-5555",
            "fax_number": "310-670-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER BERTOLDI MD PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-11",
        "last_updated": "2015-03-19",
        "status": "A",
        "authorized_official_last_name": "BERTOLDI",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "310-670-5555",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CA",
            "license": "A40519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008405191",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marian T Rofail, PHARM.D
• Peter John Roffey, M.D.
• Jeanette Rogan, RN
• George P Rogasch
• Julie Anne Rogawski, MD
• Roger Giani MD Inc
• Roger Giani MD Professional Corp
• Roger M. Kerr, M.D.,Inc
• Wendy Roger
• Angelia Cecille Rogero, FNP

• Clinical Neurophysiology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Neurophysiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; 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.