Healthcare Provider Details

I. General information

NPI: 1447940887
Provider Name (Legal Business Name): AGILE OCCUPATIONAL MEDICINE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2023
Last Update Date: 04/04/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 ROSSI CIR
SALINAS CA
93907-2370
US

IV. Provider business mailing address

3200 BRISTOL ST STE 600
COSTA MESA CA
92626-1810
US

V. Phone/Fax

Practice location:
  • Phone: 831-770-0444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PETER MURRAY
Title or Position: COO
Credential:
Phone: 571-224-5886