MEDICARE: MR. DONALD GREGORY VOGT DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	E2274	CA

General Provider Information

NPI Number	:	1497842868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DONALD GREGORY VOGT DPM

Provider Business Mailing Address
First Line	:	1621 KINGSPORT DR
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92506-5451
Country	:	US
Telephone Number	:	951-756-0454
Fax Number	:

Provider Business Practice Location Address
First Line	:	1760 CHICAGO AVE STE 3
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92507-2300
Country	:	US
Telephone Number	:	951-781-2200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	08/12/2022

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