Provider Demographics
NPI:1629132857
Name:JOANNE VOGEL MD INC
Entity Type:Organization
Organization Name:JOANNE VOGEL MD INC
Other - Org Name:SAN RAMON OB/GYN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:R
Authorized Official - Last Name:VOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-736-0110
Mailing Address - Street 1:11030 BOLLINGER CANYON RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-4874
Mailing Address - Country:US
Mailing Address - Phone:925-736-0110
Mailing Address - Fax:925-736-0120
Practice Address - Street 1:11030 BOLLINGER CANYON RD
Practice Address - Street 2:SUITE 250
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94582-4874
Practice Address - Country:US
Practice Address - Phone:925-736-0110
Practice Address - Fax:925-736-0120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64880207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ28975ZOtherMEDICARE ID