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General NPI Number Information
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NPI Number | 1154791325
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Entity Type | Individual
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Provider Name | ROY POLLOCK
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Gender | Male
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Dates
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Enumeration Date | 10/01/2015
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Last Update Date | 10/01/2015
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Provider Practice Location Address
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Address Line | 1025 WATER ST
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City | SANTA CRUZ
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State | CA
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Zip | 95062-1550
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Country | US
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Telephone | 831-464-2600
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Fax | 831-464-3904
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Provider Business Mailing Address
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Address Line | 435 MONTEREY DR
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City | APTOS
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State | CA
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Zip | 95003-4809
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Country | US
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Telephone | 831-685-8237
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Fax | 832-464-3904
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State |
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