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General NPI Number Information
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NPI Number | 1063858058
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR ASSOCIATES OF SANTA CRUZ
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Dates
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Enumeration Date | 05/16/2013
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Last Update Date | 08/05/2013
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Provider Practice Location Address
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Address Line | 1595 SOQUEL DRIVE SUITE 220
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City | SANTA CRUZ
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State | CA
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Zip | 95065-1560
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Country | US
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Telephone | 831-464-3801
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Fax | 831-464-2737
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Provider Business Mailing Address
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Address Line | 1595 SOQUEL DRIVE SUITE 220
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City | SANTA CRUZ
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State | CA
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Zip | 95065-1560
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Country | US
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Telephone | 831-464-3801
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Fax | 831-464-2737
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | DR. JAY A JOHNSON
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Credential | M.D.
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Telephone | 831-334-2316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | G73261
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License Number State | CA
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