Provider Demographics
NPI:1366543894
Name:WILLIAM C VOGELPOHL MD AND BRADLEY J KEITH MD INC
Entity type:Organization
Organization Name:WILLIAM C VOGELPOHL MD AND BRADLEY J KEITH MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:VOGELPOHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-649-4202
Mailing Address - Street 1:337 EL DORADO ST
Mailing Address - Street 2:SUITE A3
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4647
Mailing Address - Country:US
Mailing Address - Phone:831-649-4202
Mailing Address - Fax:831-649-0458
Practice Address - Street 1:337 EL DORADO ST
Practice Address - Street 2:SUITE A3
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4647
Practice Address - Country:US
Practice Address - Phone:831-649-4202
Practice Address - Fax:831-649-0458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR00761410Medicaid
CAGR00761410Medicaid