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Organization
JAY S. EDMONDS, JR., MD INC.
Active
Organization
JAY S. EDMONDS, JR., MD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY S EDMONDS JR. MD (OWNER)
(831) 375-8880
Entity
Organization
Contact information
Practice address
5 HARRIS CT, BLDG T SUITE 103, MONTEREY, CA 93940-5750
(831) 375-8880
(831) 375-8804
Mailing address
9 WALTER COLTON DR, MONTEREY, CA 93940-4230
(831) 375-8880
(831) 375-8804
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G55954
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000G559540
BLUE SHIELD
DE
01
—
G55954
BLUE CROSS
CA
Enumeration date
06/17/2006
Last updated
10/20/2010
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