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General NPI Number Information
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NPI Number | 1811027188
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Entity Type | Organization
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Legal Business Name | PHYSICIANS MEDICAL GROUP OF SANTA CRUZ, INC
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 02/18/2016
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Provider Practice Location Address
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Address Line | 100 ENTERPRISE WAY STE C110
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City | SCOTTS VALLEY
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State | CA
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Zip | 95066-3242
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Country | US
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Telephone | 831-465-7800
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Fax | 831-464-7044
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Provider Business Mailing Address
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Address Line | 100 ENTERPRISE WAY STE C110
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City | SCOTTS VALLEY
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State | CA
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Zip | 95066-3242
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Country | US
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Telephone | 831-465-7800
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Fax | 831-464-7044
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MRS. CINDY MARTIN
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Credential | COO
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Telephone | 831-465-7829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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