Healthcare Provider Details

I. General information

NPI: 1497778013
Provider Name (Legal Business Name): JOHN PETER VOGEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 11/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23600 TELO AVE 120
TORRANCE CA
90505-4035
US

IV. Provider business mailing address

729 VIA DEL MONTE
PALOS VERDES ESTATES CA
90274-1663
US

V. Phone/Fax

Practice location:
  • Phone: 310-891-6050
  • Fax: 310-891-6865
Mailing address:
  • Phone: 310-891-6050
  • Fax: 310-891-6865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG02300400
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: