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NPI Code Detail

MEDICARE: GABRIEL MILLER RASI

MEDICARE: GABRIEL MILLER RASI
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
1324500000XSubstance Abuse Rehabilitation Facility4400201120CA

General Provider Information

NPI Number : 1952712259
Entity Type Code : Individual
Provider Name (Legal Business Name) : GABRIEL MILLER RASI
Provider Business Mailing Address
First Line : 265 WATER ST
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-4009
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 265 WATER ST
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-4009
Country : US
Telephone Number : 831-425-1633
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2014
Last Update Date : 08/26/2015

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