Provider Demographics
NPI:1548398217
Name:COUNTY OF MONTEREY
Entity type:Organization
Organization Name:COUNTY OF MONTEREY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO/DIRECTOR CLINIC SERVICES DIV.
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:EDGCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-769-6522
Mailing Address - Street 1:1615 BUNKER HILL WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-6010
Mailing Address - Country:US
Mailing Address - Phone:831-769-8800
Mailing Address - Fax:831-422-9312
Practice Address - Street 1:1441 CONSTITUTION BLVD
Practice Address - Street 2:BLDG. 200, SUITE 105
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3100
Practice Address - Country:US
Practice Address - Phone:831-769-8660
Practice Address - Fax:831-769-8655
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONTEREY COUNTY HEALTH DEPT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-02
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHAP70125FOtherCOUNTY OF MONTEREY FAMPAC
CAFHC70125FMedicaid