Individual
STEVEN P FOGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4301 NORTHSTAR WAY, MODESTO, CA 95356-9262
(209) 577-1200
(209) 577-6517
Mailing address
PO BOX 576768, MODESTO, CA 95357-6768
(209) 577-1200
(209) 577-6517
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
G67570
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G67570
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G675700
DHS PPIN
CA
Enumeration date
03/20/2006
Last updated
11/04/2020
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