Provider Demographics
NPI:1023004173
Name:VOGLER, ELIZABETH MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MICHELLE
Last Name:VOGLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 489
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-0489
Mailing Address - Country:US
Mailing Address - Phone:805-434-1491
Mailing Address - Fax:805-434-4997
Practice Address - Street 1:262 POSADA LN
Practice Address - Street 2:STE C
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-4057
Practice Address - Country:US
Practice Address - Phone:805-434-1491
Practice Address - Fax:805-434-4997
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA601792085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
W14203Medicare ID - Type Unspecified
G98137Medicare UPIN
HW14203Medicare ID - Type Unspecified
W14203AMedicare ID - Type Unspecified