| Jay Pennock, Md A Professional Corporation | |
|
1595 38th Ave Capitola CA 95010-2901 | |
| (831) 226-2108 | |
| Not Available |
| Full Name | Jay Pennock, Md A Professional Corporation |
|---|---|
| Speciality | Clinic/center |
| Location | 1595 38th Ave, Capitola, California |
| Authorized Official Name and Position | Jay Pennock (OWNER AND PRESIDENT) |
| Authorized Official Contact | 8312262108 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jay Pennock, Md A Professional Corporation 1840 41st Ave Ste 102-325 Capitola CA 95010-2513 Ph: (831) 345-0652 | Jay Pennock, Md A Professional Corporation 1595 38th Ave Capitola CA 95010-2901 Ph: (831) 226-2108 |
| NPI Number | 1114016789 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 05/19/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114016789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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