Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | DC12568 | CA |
NPI | 1568768331 |
---|---|
Provider Name | Dr. Steven Winslow Vogue |
First Address | Escondido, CA 92029-5109 |
Second Address | Escondido, CA 92029-5109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2011 |
Last Update Date | 26/01/2011 |