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General NPI Number Information
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NPI Number | 1245590397
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Entity Type | Organization
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Legal Business Name | SAGE CENTERS FOR VETERINARY SPECIALTY AND EMERGENCY CARE
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Dates
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Enumeration Date | 05/23/2012
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Last Update Date | 05/23/2012
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Provider Practice Location Address
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Address Line | 1410 MONUMENT BLVD SUITE 100
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City | CONCORD
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State | CA
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Zip | 94520-4368
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Country | US
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Telephone | 925-627-7243
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Fax | 925-771-1181
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Provider Business Mailing Address
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Address Line | 1410 MONUMENT BLVD SUITE 100
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City | CONCORD
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State | CA
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Zip | 94520-4368
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Country | US
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Telephone | 925-627-7243
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Fax | 925-771-1181
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. JULIE DIANE SMITH
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Credential | DVM
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Telephone | 925-627-7243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174M00000X
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Taxonomy Name | Veterinarian
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License Number | 11677
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License Number State | CA
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