Healthcare Provider Details

I. General information

NPI: 1194789479
Provider Name (Legal Business Name): JOHN M OBERT-HONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 THE CROSSROADS BLVD STE A
CARMEL CA
93923-8685
US

IV. Provider business mailing address

100 WILSON RD STE 100
MONTEREY CA
93940-7885
US

V. Phone/Fax

Practice location:
  • Phone: 831-718-9701
  • Fax:
Mailing address:
  • Phone: 831-242-8301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036093726
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: