MR. ROGER WILLIAM SKEBELSKY


Address: 100 E Valencia Mesa Drive, 310, Fullerton, CA 92835
Phone: 7144465200

MR. ROGER WILLIAM SKEBELSKY (NPI# 1861581563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1861581563
Entity Type Individual
Full Name MR. ROGER WILLIAM SKEBELSKY
Other Name MR. ROGER WILLIAM SKEBELSKY
Credential PA-C
Practice Address 100 E Valencia Mesa Drive
310
Fullerton
CA 92835
Mailing Address 1089 Sydney Court
Upland
CA 91786-7551
Practice Telephone 7144465200
Mailing Telephone 4024031918
Enumeration Date 2006-10-12
Last Update Date 2012-05-17
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
085001305 IL Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 100 E VALENCIA MESA DRIVE
310
City FULLERTON
State CA
Zip Code 92835

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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1013487883 Austin James Perkins Physician Assistant 2141 N Harbor Blvd Ste 35000, Fullerton, CA 92835-3831 2018-12-04
1346716842 Charles Alexandre Greener Physician Assistant 2141 N Harbor Blvd Ste 35000, Fullerton, CA 92835-3831 2018-10-23
1558897413 Marie Katherine Mulcock Physician Assistant 801 E Chapman Ave Ste 203, Fullerton, CA 92831-3846 2017-05-11
1952589459 May Majied Ali Physician Assistant 100 E Valencia Mesa Dr, Suite 311, Fullerton, CA 92835-3813 2008-02-06
1275742462 Carrie-anne Clark Physician Assistant 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3813 2007-05-22
1174731640 Dennis Wayne Briley Physician Assistant 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3813 2007-05-18
1588872089 Carrie M Carrillo Physician Assistant 2141 N Harbor Blvd Ste 35000, Fullerton, CA 92835-3831 2007-05-18
1205889326 William Charles Andrew Hall Physician Assistant 2141 N Harbor Blvd, Suite 35000, Fullerton, CA 92835 2006-05-18
1912961038 Grace Jin Lee Physician Assistant 1950 Sunnycrest Dr, Suite 2600, Fullerton, CA 92835-3638 2006-04-14

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Competitor

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City FULLERTON
Zip Code 92835

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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