Healthcare Provider Details

I. General information

NPI: 1942885835
Provider Name (Legal Business Name): MONTEREY SPINE & JOINT PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2021
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 SAN JOSE ST
SALINAS CA
93901-3901
US

IV. Provider business mailing address

PO BOX 3168
SALINAS CA
93912-3168
US

V. Phone/Fax

Practice location:
  • Phone: 831-424-0807
  • Fax: 831-424-3408
Mailing address:
  • Phone: 831-424-0807
  • Fax: 831-424-3408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: DORA ELIA CHAVARRIA
Title or Position: BILLING MANAGER
Credential:
Phone: 831-375-4105