Provider Demographics
NPI:1497778013
Name:VOGEL, JOHN PETER (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PETER
Last Name:VOGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:729 VIA DEL MONTE
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-1663
Mailing Address - Country:US
Mailing Address - Phone:310-891-6050
Mailing Address - Fax:310-891-6865
Practice Address - Street 1:23600 TELO AVE
Practice Address - Street 2:120
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4035
Practice Address - Country:US
Practice Address - Phone:310-891-6050
Practice Address - Fax:310-891-6865
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2012-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG02300400208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5380018Medicare UPIN