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General NPI Number Information
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NPI Number | 1053710657
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Entity Type | Organization
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Legal Business Name | PAJARO VALLEY VETERINARY HOSPITAL
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Dates
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Enumeration Date | 08/19/2014
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Last Update Date | 08/19/2014
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Provider Practice Location Address
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Address Line | 2013 FREEDOM BLVD
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City | FREEDOM
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State | CA
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Zip | 95019-2811
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Country | US
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Telephone | 831-722-3364
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Fax |
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Provider Business Mailing Address
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Address Line | 2013 FREEDOM BLVD
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City | FREEDOM
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State | CA
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Zip | 95019-2811
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Country | US
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Telephone | 831-722-3364
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROGER BIERSTEDT
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Credential | DVM
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Telephone | 831-722-3364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | 7626
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License Number State | CA
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