Provider Demographics
NPI:1477644797
Name:OKERBLOM VOEGELE AND HOLE MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:OKERBLOM VOEGELE AND HOLE MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:OKERBLOM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-934-5140
Mailing Address - Street 1:1145 E CLARK AVE
Mailing Address - Street 2:#F
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455
Mailing Address - Country:US
Mailing Address - Phone:805-934-5140
Mailing Address - Fax:805-934-3500
Practice Address - Street 1:1145 E CLARK AVE
Practice Address - Street 2:#F
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455
Practice Address - Country:US
Practice Address - Phone:805-934-5140
Practice Address - Fax:805-934-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADE4276OtherMEDICARE RAILROAD
CADE4276OtherMEDICARE RAILROAD