Provider Demographics
NPI:1740708668
Name:VOGEL, ALISON RAMOS (DPT, OCS)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:RAMOS
Last Name:VOGEL
Suffix:
Gender:F
Credentials:DPT, OCS
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:GRACE
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, OCS
Mailing Address - Street 1:111 PENN ST
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-3908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 PENN ST
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-3908
Practice Address - Country:US
Practice Address - Phone:310-426-9570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293433225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist