Provider Demographics
NPI:1154791325
Name:POLLOCK, ROY
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:
Last Name:POLLOCK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 MONTEREY DR
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-4809
Mailing Address - Country:US
Mailing Address - Phone:831-685-8237
Mailing Address - Fax:832-464-3904
Practice Address - Street 1:1025 WATER ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-1550
Practice Address - Country:US
Practice Address - Phone:831-464-2600
Practice Address - Fax:831-464-3904
Is Sole Proprietor?:No
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver