| Jay S. Edmonds, Jr., Md Inc. | |
|
5 Harris Ct Bldg T Suite 103 Monterey CA 93940-5750 | |
| (831) 375-8880 | |
| (831) 375-8804 |
| Full Name | Jay S. Edmonds, Jr., Md Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 5 Harris Ct, Monterey, California |
| Authorized Official Name and Position | Jay S Edmonds (OWNER) |
| Authorized Official Contact | 8313758880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jay S. Edmonds, Jr., Md Inc. 9 Walter Colton Dr Monterey CA 93940-4230 Ph: (831) 375-8880 | Jay S. Edmonds, Jr., Md Inc. 5 Harris Ct Bldg T Suite 103 Monterey CA 93940-5750 Ph: (831) 375-8880 |
| NPI Number | 1114962016 |
|---|---|
| Provider Enumeration Date | 06/17/2006 |
| Last Update Date | 10/20/2010 |
| Medicare PECOS PAC ID | 8426060757 |
|---|---|
| Medicare Enrollment ID | O20060630000333 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114962016 | NPI | - | NPPES |
| G55954 | Other | CA | BLUE CROSS |
| 000G559540 | Other | DE | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G55954 (California) | Primary |
| Provider Name | Jay S Edmonds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619944881 PECOS PAC ID: 8022025907 Enrollment ID: I20060317000274 |
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