Healthcare Provider Details

I. General information

NPI: 1316174824
Provider Name (Legal Business Name): MONTEREY PHYSICIANS MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2009
Last Update Date: 09/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 CASS ST SUITE D-1
MONTEREY CA
93940-4515
US

IV. Provider business mailing address

PO BOX 1507
MONTEREY CA
93942-1507
US

V. Phone/Fax

Practice location:
  • Phone: 831-375-8500
  • Fax: 831-375-8400
Mailing address:
  • Phone: 831-375-8500
  • Fax: 831-375-8400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberA106269
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA106269
License Number StateCA

VIII. Authorized Official

Name: DR. DEBI HELENA SILJANDER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 831-375-8500