| Laurel Vista | |
|
1441 Constitution Blvd Bldg 400 Suite 301 Salinas CA 93906-3100 | |
| (831) 796-1386 | |
| Not Available |
| Full Name | Laurel Vista |
|---|---|
| Speciality | Family Medicine |
| Location | 1441 Constitution Blvd Bldg 400, 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 |
|---|---|
| Laurel Vista 1441 Schilling Place South Bldg Floor 1 Salinas CA 93901-4527 Ph: (831) 796-1308 | Laurel Vista 1441 Constitution Blvd Bldg 400 Suite 301 Salinas CA 93906-3100 Ph: (831) 796-1386 |
| NPI Number | 1033596911 |
|---|---|
| Provider Enumeration Date | 04/30/2015 |
| Last Update Date | 05/01/2018 |
| Medicare PECOS PAC ID | 2466345632 |
|---|---|
| Medicare Enrollment ID | O20150717001322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033596911 | NPI | - | NPPES |
| ZZZ02040Z | Other | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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