Healthcare Provider Details

I. General information

NPI: 1487061859
Provider Name (Legal Business Name): CALIFORNIA FORENSIC MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2511 GARDEN RD SUITE A160
MONTEREY CA
93940-5330
US

IV. Provider business mailing address

2511 GARDEN RD SUITE A160
MONTEREY CA
93940-5330
US

V. Phone/Fax

Practice location:
  • Phone: 831-649-8994
  • Fax: 831-649-8286
Mailing address:
  • Phone: 831-649-8994
  • Fax: 831-649-8286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State

VIII. Authorized Official

Name: RAYMOND KARL HERR
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 831-901-3278