Brockton Surgical Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BROCKTON SURGICAL CENTER

Practice address

5905 Brockton Avenue
Suite B
Riverside, CA 92506

Phone

(951) 686-5373

Fax

(951) 781-3661

NPI assigned

Sep 26, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Donald Gregory Vogt, DPM

Title

Administrator

Phone

(951) 686-5373

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1285735936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5905 BROCKTON AVENUE",
            "address_2": "SUITE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92506",
            "telephone_number": "951-686-5373",
            "fax_number": "951-781-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 BROCKTON AVENUE",
            "address_2": "SUITE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92506",
            "telephone_number": "951-686-5373",
            "fax_number": "951-781-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROCKTON SURGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "VOGT",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "951-686-5373",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brendon Douglas Brockmann, MD
• Lynne M Brockmeier
• Brockton Dental X-Ray Lab., Inc.
• Brockton Endoscopy Surgery Center LP
• Brockton Investments & Associates, LLC
• Divine Grace Fernandez Broich
• Aijalon Benet Brooks
• Byron Brooks, MHRS
• Cleveland Malcolm Brooks
• Hunter Brooks

• Ambulatory Surgical Clinic/Center in Riverside, CA
• Providers in Riverside, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.