Provider Demographics
NPI:1407254477
Name:COUNTY OF MONTEREY
Entity Type:Organization
Organization Name:COUNTY OF MONTEREY
Other - Org Name:BIENESTAR KING CITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/COO CLINIC SERVICES BUREAU
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:CLAIRE
Authorized Official - Last Name:EDGCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-796-1386
Mailing Address - Street 1:1615 BUNKER HILL WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-6013
Mailing Address - Country:US
Mailing Address - Phone:831-796-1386
Mailing Address - Fax:
Practice Address - Street 1:200 BROADWAY ST
Practice Address - Street 2:SUITE 70
Practice Address - City:KING CITY
Practice Address - State:CA
Practice Address - Zip Code:93930-2865
Practice Address - Country:US
Practice Address - Phone:831-769-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONTEREY COUNTY HEALTH DEPARTMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty