Kenneth Jay Vogan Jr., CSNC
Specialist/Technologist, Athletic Trainer in San Diego, CA. Individual provider (NPI-1).
NPI number1114701034
StatusActive
Last updated in NPPESNov 25, 2023
Details
- NPI
- 1114701034
- Entity type
- Individual (NPI-1)
- Name
- Kenneth Jay Vogan Jr.
- Credential
- CSNC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 22, 2023
- Certification date
- Nov 25, 2023
- Last updated
- Nov 25, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
Practice location
3900 Lomaland DrSan Diego, CA 92106-2810
Phone 619-849-2442
Mailing address
3900 Lomaland DrSan Diego, CA 92106-2810
Phone 619-577-0697
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