Provider Demographics
NPI:1649203522
Name:VOGUS, JAMES B (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:B
Last Name:VOGUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 496084
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96049-6084
Mailing Address - Country:US
Mailing Address - Phone:530-241-0473
Mailing Address - Fax:530-241-5377
Practice Address - Street 1:3328 CHURN CREEK RD
Practice Address - Street 2:STE A
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2513
Practice Address - Country:US
Practice Address - Phone:530-222-0895
Practice Address - Fax:530-222-0705
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG86571207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G865710Medicaid
CAF18319Medicare UPIN
CA00G865710Medicare ID - Type Unspecified