NPIMap

Organization Active NPI

County of Mono

  • Public Health or Welfare Agency
  • Mammoth Lakes, CA
National Provider Identifier
1487770459
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
COUNTY OF MONO
Practice address
1290 Tavern Rd Ste 246
Mammoth Lakes, CA 93546-6603
Phone
(760) 924-1830
Fax
(760) 924-1831
NPI assigned
Mar 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sandra Moberly
Title
Cao
Phone
(760) 932-5414

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

1290 Tavern Rd Ste 246
Mammoth Lakes, CA 93546-6603

Mailing address

PO Box 476
Bridgeport, CA 93517-0476
Phone (760) 932-5580

Other practice location 1

37 Emigrant Street
Bridgeport, CA 93517-0476
Phone (760) 932-5580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090309000312 CA Part B Supplier - Mass Immunization (Roster Biller Only) 8527045665 Practice locations: Bridgeport, CA; Mammoth Lakes, CA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
County of Mono6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706227200000",
    "number": "1487770459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 476",
            "city": "BRIDGEPORT",
            "state": "CA",
            "postal_code": "935170476",
            "telephone_number": "760-932-5580",
            "fax_number": "760-932-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 TAVERN RD STE 246",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935466603",
            "telephone_number": "760-924-1830",
            "fax_number": "760-924-1831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37 Emigrant Street",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CA",
            "postal_code": "935170476",
            "country_code": "US",
            "telephone_number": "760-932-5580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COUNTY OF MONO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A",
        "authorized_official_last_name": "MOBERLY",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "760-932-5414"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mammoth Lakes, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.