Organization Active NPI

Pacific Grove Medical Clinic, Inc

  • Internal Medicine Physician
  • Pacific Grove, CA
National Provider Identifier
1962585133
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PACIFIC GROVE MEDICAL CLINIC, INC
Practice address
505 Central Ave
Ste 201
Pacific Grove, CA 93950
Phone
(831) 645-9990
Fax
(831) 645-9993
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Authorized official

Name
Michael Manig, MD
Title
President Owner
Phone
(831) 645-9990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

505 Central Ave
Ste 201
Pacific Grove, CA 93950

Mailing address

505 Central Ave, Suite 201
Pacific Grove, CA 93950
Phone (831) 645-9990

National Provider Directory

National Provider Directory

Locations

505 Central Ave
Ste 201
Pacific Grove, CA 93950
Phone (831) 645-9990

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1962585133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 CENTRAL AVE, SUITE 201",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "93950",
            "telephone_number": "831-645-9990",
            "fax_number": "831-645-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 CENTRAL AVE",
            "address_2": "STE 201",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "93950",
            "telephone_number": "831-645-9990",
            "fax_number": "831-645-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC GROVE MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "MANIG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "831-645-9990",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.