Healthcare Provider Details

I. General information

NPI: 1881620599
Provider Name (Legal Business Name): MONTEREY SPINE & JOINT PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 06/18/2021
Certification Date: 01/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 UPPER RAGSDALE DR
MONTEREY CA
93940-5730
US

IV. Provider business mailing address

PO BOX 3168
SALINAS CA
93912
US

V. Phone/Fax

Practice location:
  • Phone: 831-648-7200
  • Fax: 831-648-7204
Mailing address:
  • Phone: 831-649-1000
  • Fax: 831-649-4961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SOHRAB GOLLOGLY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 831-648-7200