Organization
BROCKTON SURGICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD GREGORY VOGT DPM (ADMINISTRATOR)
(951) 686-5373
Entity
Organization
Contact information
Practice address
5905 BROCKTON AVENUE, SUITE B, RIVERSIDE, CA 92506
(951) 686-5373
(951) 781-3661
Mailing address
5905 BROCKTON AVENUE, SUITE B, RIVERSIDE, CA 92506
(951) 686-5373
(951) 781-3661
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/26/2006
Last updated
12/11/2007
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