Healthcare Provider Details
I. General information
NPI: 1669500336
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: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1156 FREMONT BLVD
SEASIDE CA
93955-5756
US
IV. Provider business mailing address
1441 SCHILLING PLACE SOUTH BUILDING - FIRST FLOOR
SALINAS CA
93901-4527
US
V. Phone/Fax
- Phone: 831-899-8100
- Fax: 831-899-8105
- Phone: 831-769-8800
- Fax: 831-422-9312
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name:
JULIA
CLAIRE
EDGCOMB
Title or Position: DIRECTOR/COO CLINIC SERVICES DIV
Credential:
Phone: 831-769-6522