| |
1441 Constitution Blvd Bldg 400, Suite 300 Salinas CA 93906-3100 | |
(831) 755-4123 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 1441 Constitution Blvd, Salinas, California |
Authorized Official Name and Position | Julia Claire Edgcomb (DIRECTOR/COO CLINIC SERVICES DIV.) |
Authorized Official Contact | 8317961386 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1441 Schilling Place South Bldg Floor 1 Salinas CA 93901-4527 Ph: (831) 796-1308 | 1441 Constitution Blvd Bldg 400, Suite 300 Salinas CA 93906-3100 Ph: (831) 755-4123 |
NPI Number | 1740232644 |
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Provider Enumeration Date | 05/17/2006 |
Last Update Date | 05/01/2018 |
Medicare PECOS PAC ID | 2466345632 |
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Medicare Enrollment ID | O20091016000078 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740232644 | NPI | - | NPPES |
FHC70125F | Medicaid | CA | |
HAP70125F | Other | CA | FAMPACT |
ZZZ02040Z | Other | CA | PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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