Provider Demographics
NPI:1982621934
Name:MONTEREY BAY INPATIENT PHYS
Entity Type:Organization
Organization Name:MONTEREY BAY INPATIENT PHYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OFFICER OF CORP
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-622-2708
Mailing Address - Street 1:PO BOX 6178
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93912
Mailing Address - Country:US
Mailing Address - Phone:831-622-2708
Mailing Address - Fax:831-622-2709
Practice Address - Street 1:23625 WR HOLMAN HWY
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940
Practice Address - Country:US
Practice Address - Phone:831-622-2708
Practice Address - Fax:831-622-2709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ21867ZMedicare ID - Type Unspecified