Provider Demographics
NPI:1366700452
Name:VOGELL, TROY VINCENT II
Entity type:Individual
Prefix:MR
First Name:TROY
Middle Name:VINCENT
Last Name:VOGELL
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 848
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-0848
Mailing Address - Country:US
Mailing Address - Phone:909-825-5588
Mailing Address - Fax:909-430-0871
Practice Address - Street 1:2760 LAKE SAHARA DR
Practice Address - Street 2:SUITE 108
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-3438
Practice Address - Country:US
Practice Address - Phone:702-222-0792
Practice Address - Fax:702-222-9572
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator