1407944119 NPI number — BETH WHARTON MILFORD MD

Table of content: BETH WHARTON MILFORD MD (NPI 1407944119)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407944119 NPI number — BETH WHARTON MILFORD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILFORD
Provider First Name:
BETH
Provider Middle Name:
WHARTON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MILFORD
Provider Other First Name:
BETH
Provider Other Middle Name:
WHARTON
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1407944119
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1441 CONSTITUTION BOULEVARD
Provider Second Line Business Mailing Address:
BUILDING 400, SUITE 202
Provider Business Mailing Address City Name:
SALINAS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94906
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-625-2526
Provider Business Mailing Address Fax Number:
831-769-0552

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 AGUAJITO RD
Provider Second Line Business Practice Location Address:
MONTEREY COUNTY BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
MONTEREY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93940-4887
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-625-2526
Provider Business Practice Location Address Fax Number:
831-769-0552
Provider Enumeration Date:
10/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  G33280 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00G332800 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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