Organization
JOSEPH P FOGEL MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARLA CORNACCHIA (MANAGER)
(831) 464-6200
Entity
Organization
Contact information
Practice address
824 BAY AVE, STE 70, CAPITOLA, CA 95010-2104
(831) 464-6200
(831) 464-6204
Mailing address
824 BAY AVE, STE 70, CAPITOLA, CA 95010-2104
(831) 464-6200
(831) 464-6204
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
A35774
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A357740
—
CA
Enumeration date
11/28/2006
Last updated
02/07/2008
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