Provider Demographics
NPI:1841647476
Name:VOGEL, SARAH (LAC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:VOGEL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1595 LINWOOD ST APT B
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3774
Mailing Address - Country:US
Mailing Address - Phone:573-275-4070
Mailing Address - Fax:
Practice Address - Street 1:1595 LINWOOD ST APT B
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-3774
Practice Address - Country:US
Practice Address - Phone:573-275-4070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17174171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist