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General NPI Number Information
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NPI Number | 1902123243
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Entity Type | Organization
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Legal Business Name | 60TH MEDGRP-TRAVIS
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Dates
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Enumeration Date | 04/27/2010
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 473 CABRILLO ST A-102
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City | MONTEREY
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State | CA
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Zip | 93944-3201
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Country | US
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Telephone | 831-242-5382
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Fax | 831-242-5809
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Provider Business Mailing Address
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Address Line | 473 CABRILLO ST A-102
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City | MONTEREY
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State | CA
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Zip | 93944-3201
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Country | US
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Telephone | 831-242-5382
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Fax | 831-242-5809
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Authorized Official
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Title or Position | CHIEF DHA PASS
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Name | HECTOR MORALES
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Credential |
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Telephone | 210-536-6650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332000000X
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Taxonomy Name | Military/U.S. Coast Guard Pharmacy
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License Number |
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License Number State |
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