Healthcare Provider Details

I. General information

NPI: 1760689699
Provider Name (Legal Business Name): DAVID G. DEMARA PAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 SAN JOSE ST STE 301
SALINAS CA
93901-3928
US

IV. Provider business mailing address

100 WILSON RD STE 100
MONTEREY CA
93940-7885
US

V. Phone/Fax

Practice location:
  • Phone: 831-649-1000
  • Fax:
Mailing address:
  • Phone: 831-649-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number25MP00052300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA62420
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: