Advanced Gastroenterology of Monterey County Medical Corp
Organization Active NPI Gastroenterology Physician · Salinas, CA
NPI 1285780692 · NPPES record last updated Feb 14, 2018
Key facts
- NPI
- 1285780692
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- License
- A54688 (CA)
- Legal business name
- ADVANCED GASTROENTEROLOGY OF MONTEREY COUNTY MEDICAL CORP
- Practice address
- 1441 Constitution Blvd
Salinas, CA 93906-3100 - Phone
- (831) 755-6352
- Fax
- (831) 755-6297
- NPI assigned
- Jan 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Mumtaz Tabbaa, M.D.
- Title
- Owner
- Phone
- (831) 755-6352
National Provider Directory
Locations
1441 Constitution Blvd
Bldg B
Salinas, CA 93906
Phone (831) 755-4156
1441 Constitution Blvd
#B
Salinas, CA 93906
1441 Constitution Blvd
Ste 13
Salinas, CA 93906
Phone (831) 755-4156
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician |
207RG0100X | A54688 | CA | Yes |
Addresses
Primary practice location
1441 Constitution Blvd
Salinas, CA 93906-3100
Mailing address
395 Del Monte Center Ste 173
Monterey, CA 93940-6156
Phone (831) 755-6352
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A546880 | Medicaid | CA |
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.