Organization
MONTEREY BAY ONCOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DORA MORENO CMC (BILLING MANAGER)
(831) 642-4060
Entity
Organization
Contact information
Practice address
5 HARRIS CT BLDG T2ND, MONTEREY, CA 93940-5750
(831) 375-4105
(831) 372-5722
Mailing address
5 HARRIS CT BLDG T, 2ND FLOOR SUITE 201, MONTEREY, CA 93940-5750
(831) 375-4105
(831) 372-5722
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0590281
CLIA
CA
01
—
05D0691381
CLIA
CA
01
—
5640924
NCPDP
CA
05
—
GR0076250
—
CA
01
—
ZZZ71527Z
BLUE SHIELD
—
Enumeration date
03/14/2008
Last updated
10/12/2017
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