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MONTEREY OBGYN MEDICAL GROUP INC NPI 1881861797


NPI Information

NPI: 1881861797
Provider Name: MONTEREY OBGYN MEDICAL GROUP INC
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 05D0887377

Address:
72780 COUNTRY CLUB DR STE A103
RANCHO MIRAGE, CA
ZIP 92270
Phone: (760) 779-5511
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MONTEREY OBGYN MEDICAL GROUP INC is a specialist in Rancho Mirage, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MONTEREY OBGYN MEDICAL GROUP INC NPI is 1881861797. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

72780 COUNTRY CLUB DR STE A103
RANCHO MIRAGE, CA
ZIP 92270
Phone: (760) 779-5511
Fax: (760) 773-3320

The provider's authorized official is Enrique G Jacome .
The authorized official title is Owner/physician and has the following contact phone number (760) 779-5511.

The CLIA number assigned to this NPI record is 05D0887377 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/9/2008 and was last updated on 5/9/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistA44682CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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