Organization
PEDIATRIC GASTROENTEROLOGY OF MONTEREY INC.
Active
Organization
PEDIATRIC GASTROENTEROLOGY OF MONTEREY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDERS KARL DAHLSTROM M.D. PH.D. (PRESIDENT (OF CORPORATION)/CEO)
(831) 626-3259
Entity
Organization
Contact information
Practice address
1900 GARDEN ROAD SUITE 110, PEDIATRIC GROUP OF MONTEREY, MONTEREY, CA 93940
(831) 626-3259
(888) 860-1110
Mailing address
PO BOX 204, PEBBLE BEACH, CA 93953
(831) 626-3259
(888) 860-1110
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
A52400
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A52400
CALIFORNIA STATE LICENCE
CA
Enumeration date
01/19/2010
Last updated
03/18/2010
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