Joseph P Fogel MD Inc

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

A35774 Issued in CA

Legal business name

JOSEPH P FOGEL MD INC

Practice address

824 Bay Ave
Ste 70
Capitola, CA 95010-2104

Phone

(831) 464-6200

Fax

(831) 464-6204

NPI assigned

Nov 28, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Carla Cornacchia

Title

Manager

Phone

(831) 464-6200

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202342400000",
    "number": "1962578377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 BAY AVE",
            "address_2": "STE 70",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102104",
            "telephone_number": "831-464-6200",
            "fax_number": "831-464-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 BAY AVE",
            "address_2": "STE 70",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102104",
            "telephone_number": "831-464-6200",
            "fax_number": "831-464-6204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH P FOGEL MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2008-02-07",
        "status": "A",
        "authorized_official_last_name": "CORNACCHIA",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "831-464-6200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "A35774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A357740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Orthopaedic Surgery) Physician in Capitola, CA
• Providers in Capitola, CA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.