Healthcare Provider Details

I. General information

NPI: 1720543028
Provider Name (Legal Business Name): EDUARDO MUNOZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2019
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 CHURCH ST
SALINAS CA
93901-2632
US

IV. Provider business mailing address

130 W GABILAN ST
SALINAS CA
93901-2762
US

V. Phone/Fax

Practice location:
  • Phone: 831-755-8155
  • Fax: 831-422-9411
Mailing address:
  • Phone: 831-755-8155
  • Fax: 831-422-9411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: