Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY26956 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY26956 | CA |
NPI | 1003282385 |
---|---|
Provider Name | Dr. Adam Vogel |
First Address | Los Angeles, CA 90005-4000 |
Second Address | Los Angeles, CA 90005-4000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2015 |
Last Update Date | 24/09/2015 |