Provider Demographics
NPI:1316010523
Name:PRECISION HEALTH AND REHABILITATION
Entity Type:Organization
Organization Name:PRECISION HEALTH AND REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:VEGHER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:831-464-8200
Mailing Address - Street 1:9000 SOQUEL AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2097
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9000 SOQUEL AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2097
Practice Address - Country:US
Practice Address - Phone:831-464-8200
Practice Address - Fax:831-477-2924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT20895225100000X
CAOT181225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT208950Medicare UPIN