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General NPI Number Information
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NPI Number | 1023265642
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Entity Type | Organization
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Legal Business Name | SCOTT P DALY SANTA CRUZ OPTOMETRIC
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Dates
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Enumeration Date | 08/26/2008
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Last Update Date | 08/17/2017
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Provider Practice Location Address
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Address Line | 3275 APTOS RANCHO RD SUITE B
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City | APTOS
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State | CA
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Zip | 95003-3983
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Country | US
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Telephone | 831-685-1050
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Fax | 831-685-1059
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Provider Business Mailing Address
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Address Line | 904 CEDAR ST
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City | SANTA CRUZ
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State | CA
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Zip | 95060-3802
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Country | US
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Telephone | 831-426-1050
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Fax | 831-423-1050
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Authorized Official
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Title or Position | BOOKKEEPER
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Name | KATHY DALY
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Credential |
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Telephone | 831-426-1050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7785
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License Number State | CA
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