Provider Demographics
NPI:1487070553
Name:VERTREES, ROGER (PHD)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:
Last Name:VERTREES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:555 KNOWLES DRIVE
Mailing Address - Street 2:STE 203
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1551
Mailing Address - Country:US
Mailing Address - Phone:408-827-4274
Mailing Address - Fax:408-358-8692
Practice Address - Street 1:555 KNOWLES DRIVE
Practice Address - Street 2:STE 203
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1551
Practice Address - Country:US
Practice Address - Phone:408-827-4274
Practice Address - Fax:408-358-8692
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist