Provider Demographics
NPI:1033202072
Name:MAMMOGRAPHY CENTER OF MONTEREY
Entity Type:Organization
Organization Name:MAMMOGRAPHY CENTER OF MONTEREY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY LOU
Authorized Official - Middle Name:
Authorized Official - Last Name:CATANIA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:831-373-8932
Mailing Address - Street 1:700 CASS ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2916
Mailing Address - Country:US
Mailing Address - Phone:831-373-8932
Mailing Address - Fax:831-373-5465
Practice Address - Street 1:700 CASS ST
Practice Address - Street 2:SUITE #120
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2916
Practice Address - Country:US
Practice Address - Phone:831-373-8932
Practice Address - Fax:831-373-5465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43703261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ13550ZMedicare PIN