Healthcare Provider Details

I. General information

NPI: 1124156898
Provider Name (Legal Business Name): COUNTY OF MONTEREY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 08/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 CONSTITUTION BLVD BLDG. 200, SUITE 101
SALINAS CA
93906-3100
US

IV. Provider business mailing address

1441 SCHILLING PLACE SOUTH BLDG - FIRST FLOOR - HEALTH DEPT CLINIC SERVICES
SALINAS CA
93901-4527
US

V. Phone/Fax

Practice location:
  • Phone: 831-755-4124
  • Fax: 831-755-7077
Mailing address:
  • Phone: 831-796-1386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: JULIA CLAIRE EDGCOMB
Title or Position: DIRECTOR/COO CLINIC SERVICES DIV
Credential:
Phone: 831-769-6522