Provider Demographics
NPI:1629185426
Name:VOGEL, RONALD RAY (DPM)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:RAY
Last Name:VOGEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 E 1ST AVE STE 9
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3547
Mailing Address - Country:US
Mailing Address - Phone:530-342-5621
Mailing Address - Fax:
Practice Address - Street 1:12717 N AVONDALE LOOP
Practice Address - Street 2:
Practice Address - City:HAYDEN
Practice Address - State:ID
Practice Address - Zip Code:83835-7531
Practice Address - Country:US
Practice Address - Phone:208-772-9342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1234213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6980019Medicaid
CAT10846Medicare UPIN
CA6980019Medicaid