Provider Demographics
NPI:1740205715
Name:VEGA, MICHAEL ROBLES (DPM)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ROBLES
Last Name:VEGA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1577 LAS PALOMAS DR
Mailing Address - Street 2:
Mailing Address - City:LA HABRA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:90631-8007
Mailing Address - Country:US
Mailing Address - Phone:562-713-5200
Mailing Address - Fax:
Practice Address - Street 1:13132 STUDEBAKER RD STE A
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2573
Practice Address - Country:US
Practice Address - Phone:562-888-5944
Practice Address - Fax:562-888-5945
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2960213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGRE000310Medicaid
WE2960EOtherMEDICARE PTAN
CAWE2960FOtherMEDICARE PTAN
CAGRE000311Medicaid
CA1101320Medicaid
CA480009960OtherRAILROAD
CAGRE000311Medicaid
CA1285640649OtherMEDICARE GROUP NPI
WE2960EOtherMEDICARE PTAN
CADA3847OtherRAILROAD
CA1538175997OtherMEDICARE GROUP NPI
CAGRE000310Medicaid
CA0955160001Medicare NSC
CADA3847OtherRAILROAD