Provider Demographics
NPI:1831477306
Name:BOLLINGER CANYON ANIMAL HOSPITAL INC.
Entity Type:Organization
Organization Name:BOLLINGER CANYON ANIMAL HOSPITAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VETERINARIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:925-866-8500
Mailing Address - Street 1:400 MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4777
Mailing Address - Country:US
Mailing Address - Phone:925-866-8500
Mailing Address - Fax:877-821-9288
Practice Address - Street 1:400 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4777
Practice Address - Country:US
Practice Address - Phone:925-866-8500
Practice Address - Fax:877-821-9288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHSP6398174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174M00000XOther Service ProvidersVeterinarianGroup - Single Specialty