Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic | |
Family Medicine |
207Q00000X | 08 | Physician/Family Practice |
| NPI # | 1497339790 |
| LBN Legal business name | MONTEREY MEDICAL LLC |
| Authorized official | CRYSTAL VAUGHN - (VICE PRESIDENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 05/12/2021 |
| Last updated | 07/08/2021 - About 5 years ago |
| Identifiers | n/a |
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MONTEREY MEDICAL LLC
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