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General NPI Number Information
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NPI Number | 1790027498
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Entity Type | Organization
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Legal Business Name | SCOTTS VALLEY VETERINARY CLINIC, INC.
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Dates
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Enumeration Date | 03/20/2013
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Last Update Date | 03/20/2013
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Provider Practice Location Address
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Address Line | 4257 SCOTTS VALLEY DR
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City | SCOTTS VALLEY
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State | CA
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Zip | 95066-4521
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Country | US
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Telephone | 831-438-2600
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Fax | 831-438-0169
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Provider Business Mailing Address
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Address Line | 4257 SCOTTS VALLEY DR
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City | SCOTTS VALLEY
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State | CA
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Zip | 95066-4521
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Country | US
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Telephone | 831-438-2600
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Fax | 831-438-0169
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Authorized Official
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Title or Position | CEO
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Name | DR. CHARLES ROBERT MILLER JR.
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Credential | D.V.M.
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Telephone | 831-438-2600
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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 | VET6932
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License Number State | CA
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