Healthcare Provider Details

I. General information

NPI: 1154577484
Provider Name (Legal Business Name): STEVEN CHARLES VERA C.O., C.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 11/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 HOSPITAL DR SUITE G-2
SACRAMENTO CA
95823-5406
US

IV. Provider business mailing address

7600 HOSPITAL DR SUITE G-2
SACRAMENTO CA
95823-5406
US

V. Phone/Fax

Practice location:
  • Phone: 916-896-5702
  • Fax: 916-896-5703
Mailing address:
  • Phone: 916-896-5702
  • Fax: 916-896-5703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: