MEDICARE: MR. JAMES VEGHER PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT20895	CA

General Provider Information

NPI Number	:	1134200694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES VEGHER PT

Provider Business Mailing Address
First Line	:	8030 SOQUEL AVE
Second Line	:	STE 200
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-2096
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9000 SOQUEL AVE
Second Line	:	103
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-2097
Country	:	US
Telephone Number	:	831-464-8200
Fax Number	:	831-477-7274

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	03/27/2018

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