Lawrence J Fogel, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

G18977 Issued in CA

Practice address

628 California Blvd
Suite a-3
San Luis Obispo, CA 93401-2542

Phone

(805) 543-1683

Fax

(805) 543-3516

NPI assigned

Nov 29, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1649253162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 CALIFORNIA BLVD",
            "address_2": "SUITE A-3",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012542",
            "telephone_number": "805-543-1683",
            "fax_number": "805-543-3516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 CALIFORNIA BLVD",
            "address_2": "SUITE A-3",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012542",
            "telephone_number": "805-543-1683",
            "fax_number": "805-543-3516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGEL",
        "first_name": "LAWRENCE",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G18977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "120995100",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G189770",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G189770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Flores, DMD
• Janet Dorothy Florez, MFT-I
• Flourish and Grow Family Therapy, Inc.
• Lisa A Flynn, PA-C
• Toni Kathleen Flynn, LPT
• Anthony J Folino, M.A., LPCC
• Karen Ann Fong, MD
• Rachel Fonzi, RN
• Susan Luellia Foote, DPO 11
• Beverly J Ford, PHD

• Neurology Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.