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General NPI Number Information
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NPI Number | 1891169801
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Entity Type | Organization
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Legal Business Name | MONTEREY BAY CENTER FOR INTEGRATED HEALTH
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Dates
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Enumeration Date | 11/15/2015
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Last Update Date | 11/15/2015
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Provider Practice Location Address
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Address Line | 284 FOREST RIDGE RD
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City | MONTEREY
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State | CA
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Zip | 93940-4101
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Country | US
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Telephone | 831-236-5802
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Fax |
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Provider Business Mailing Address
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Address Line | 284 FOREST RIDGE RD
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City | MONTEREY
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State | CA
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Zip | 93940-4101
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Country | US
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Telephone | 831-236-5802
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. MICHAEL C HENDRICKSON
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Credential | PHD
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Telephone | 8318312365802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 312972
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License Number State | CA
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