Healthcare Provider Details

I. General information

NPI: 1417818642
Provider Name (Legal Business Name): DR MICHAEL VEGA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 W WHITTIER BLVD
MONTEBELLO CA
90640-4642
US

IV. Provider business mailing address

1577 LAS PALOMAS DR
LA HABRA HEIGHTS CA
90631-8007
US

V. Phone/Fax

Practice location:
  • Phone: 323-728-6070
  • Fax:
Mailing address:
  • Phone: 562-713-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL R VEGA
Title or Position: PRESIDENT
Credential: DPM
Phone: 562-713-5200