Provider Demographics
NPI:1659460210
Name:VOGT, ELEANOR MARY (RPH,PHD)
Entity Type:Individual
Prefix:DR
First Name:ELEANOR
Middle Name:MARY
Last Name:VOGT
Suffix:
Gender:F
Credentials:RPH,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1998 BROADWAY
Mailing Address - Street 2:# 902
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-2281
Mailing Address - Country:US
Mailing Address - Phone:415-502-7515
Mailing Address - Fax:415-502-0792
Practice Address - Street 1:3333 CALIFORNIA ST
Practice Address - Street 2:420E
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1981
Practice Address - Country:US
Practice Address - Phone:415-502-7515
Practice Address - Fax:415-502-0792
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7622-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist