Healthcare Provider Details

I. General information

NPI: 1588617955
Provider Name (Legal Business Name): COUNTY OF MONTEREY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 06/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3155 DE FOREST RD.
MARINA CA
93933-2702
US

IV. Provider business mailing address

1441 SCHILLING PLACE SOUTH BLDG FLOOR 1
SALINAS CA
93901-4527
US

V. Phone/Fax

Practice location:
  • Phone: 831-384-1445
  • Fax: 831-384-1454
Mailing address:
  • Phone: 831-796-1308
  • Fax: 831-757-0291

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 DIV.
Credential:
Phone: 831-796-1386