Organization
COUNTY OF MONO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA MOBERLY (CAO)
(760) 932-5414
Entity
Organization
Contact information
Practice address
1290 TAVERN RD STE 246, MAMMOTH LAKES, CA 93546-6603
(760) 924-1830
(760) 924-1831
Mailing address
PO BOX 476, BRIDGEPORT, CA 93517-0476
(760) 932-5580
(760) 932-5284
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
03/22/2007
Last updated
01/26/2024
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