DOUGLAS LEE ROEN PA NPI 1457498453

NPI Information

NPI: 1457498453
Provider Name: DOUGLAS LEE ROEN, PA
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Organization: PERMANENTE MEDICAL GROUP INC

PECOS Registration: Yes

Address:
275 W MACARTHUR BLVD
OAKLAND, CA
ZIP 94611
Phone: (510) 752-1000
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Douglas Lee Roen, PA is a surgical physician assistant in Oakland, CA with 23 years of experience. Douglas Lee Roen, PA NPI is 1457498453. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

275 W MACARTHUR BLVD
OAKLAND, CA
ZIP 94611-641
Phone: (510) 752-1000
Fax: (510) 752-6674

The NPI 1457498453 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/30/2007 and was last updated on 1/3/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	16016	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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