Provider Demographics
NPI:1114786373
Name:GREGORY SHOLEFF MD INC
Entity Type:Organization
Organization Name:GREGORY SHOLEFF MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-375-8822
Mailing Address - Street 1:50 RAGSDALE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-7804
Mailing Address - Country:US
Mailing Address - Phone:831-375-8824
Mailing Address - Fax:831-375-8804
Practice Address - Street 1:50 RAGSDALE DR STE 120
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-7804
Practice Address - Country:US
Practice Address - Phone:831-375-8824
Practice Address - Fax:831-375-8804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty