Healthcare Provider Details

I. General information

NPI: 1205007408
Provider Name (Legal Business Name): MONTEREY BAY ONCOLOGY A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2008
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 HARRIS CT BLDG T SUITE 201
MONTEREY CA
93940-5750
US

IV. Provider business mailing address

5 HARRIS CT BLDG T 2ND FLOOR SUITE 201
MONTEREY CA
93940-5750
US

V. Phone/Fax

Practice location:
  • Phone: 831-375-4105
  • Fax: 831-372-5722
Mailing address:
  • Phone: 831-375-4105
  • Fax: 831-372-5722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: NICOLE LYNN BILLINGSLEY
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 831-375-4105