# BROCKTON SURGICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285735936
- **Authorized official:** MR. DONALD GREGORY VOGT DPM (ADMINISTRATOR)
- **Authorized official phone:** (951) 686-5373

## Contact information

- **Practice address:** 5905 BROCKTON AVENUE, SUITE B, RIVERSIDE, CA 92506
- **Practice address phone:** (951) 686-5373
- **Practice address fax:** (951) 781-3661
- **Mailing address:** 5905 BROCKTON AVENUE, SUITE B, RIVERSIDE, CA 92506
- **Mailing address phone:** (951) 686-5373
- **Mailing address fax:** (951) 781-3661

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/26/2006
- **Last updated:** 12/11/2007