Organization
MONTEREY BAY CENTER FOR INTEGRATED HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL C HENDRICKSON PHD (PRESIDENT/CEO)
8318312365802
Entity
Organization
Contact information
Practice address
284 FOREST RIDGE RD, MONTEREY, CA 93940-4101
(831) 236-5802
Mailing address
284 FOREST RIDGE RD, MONTEREY, CA 93940-4101
(831) 236-5802
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
312972
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA147502
MEDICARE PTAN
CA
Enumeration date
11/15/2015
Last updated
11/15/2015
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