Provider Demographics
NPI:1548846439
Name:VOGEL, CAROLINA (DO)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:VOGEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 PARK PL STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-7119
Mailing Address - Country:US
Mailing Address - Phone:415-502-8950
Mailing Address - Fax:415-502-8954
Practice Address - Street 1:1100 PARK PL
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1599
Practice Address - Country:US
Practice Address - Phone:415-502-8940
Practice Address - Fax:415-502-8934
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A23046207Q00000X
IN110221796A390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine