Healthcare Provider Details

I. General information

NPI: 1407254477
Provider Name (Legal Business Name): COUNTY OF MONTEREY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2014
Last Update Date: 12/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BROADWAY ST SUITE 70
KING CITY CA
93930-2865
US

IV. Provider business mailing address

1615 BUNKER HILL WAY SUITE 100
SALINAS CA
93906-6013
US

V. Phone/Fax

Practice location:
  • Phone: 831-769-8800
  • Fax:
Mailing address:
  • Phone: 831-796-1386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JULIA CLAIRE EDGCOMB
Title or Position: DIRECTOR/COO CLINIC SERVICES BUREAU
Credential:
Phone: 831-796-1386