Healthcare Provider Details

I. General information

NPI: 1043717283
Provider Name (Legal Business Name): ABRAHAM VELA JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 10/01/2023
Certification Date: 10/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1931 MAIN ST
WATSONVILLE CA
95076-3027
US

IV. Provider business mailing address

440 AIRPORT BLVD
SALINAS CA
93905-3302
US

V. Phone/Fax

Practice location:
  • Phone: 831-768-6600
  • Fax:
Mailing address:
  • Phone: 831-757-8689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA174075
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA174075
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: