Provider Demographics
NPI:1942371208
Name:GOGATZ, ROBERT W II (DC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:W
Last Name:GOGATZ
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40485 MURRIETA HOT SPRINGS RD
Mailing Address - Street 2:SUITE B-7
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-6406
Mailing Address - Country:US
Mailing Address - Phone:951-698-4050
Mailing Address - Fax:951-698-4057
Practice Address - Street 1:40485 MURRIETA HOT SPRINGS RD
Practice Address - Street 2:SUITE B-7
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-6406
Practice Address - Country:US
Practice Address - Phone:951-698-4050
Practice Address - Fax:951-698-4057
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19801111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC19801Medicare ID - Type Unspecified