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General NPI Number Information
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NPI Number | 1114704616
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Entity Type | Organization
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Legal Business Name | MONTEREY MED INK LLC
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Dates
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Enumeration Date | 09/11/2023
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 1011 CASS ST STE 102E
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City | MONTEREY
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State | CA
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Zip | 93940-4531
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Country | US
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Telephone | 831-601-0930
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Fax |
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Provider Business Mailing Address
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Address Line | 3012 SUNRISE AVE
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City | MARINA
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State | CA
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Zip | 93933-4017
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Country | US
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Telephone | 831-601-0930
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASHLEY DEBBIE HERNANDEZ
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Credential |
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Telephone | 831-601-0930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number |
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License Number State |
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