Provider Demographics
NPI:1194807818
Name:WILLIAM E. MONK, M.D., INC
Entity type:Organization
Organization Name:WILLIAM E. MONK, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:EMERY
Authorized Official - Last Name:MONK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-427-3361
Mailing Address - Street 1:480 4TH AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-4410
Mailing Address - Country:US
Mailing Address - Phone:619-427-3361
Mailing Address - Fax:619-427-6821
Practice Address - Street 1:480 4TH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-4410
Practice Address - Country:US
Practice Address - Phone:619-427-3361
Practice Address - Fax:619-427-6821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0083510Medicaid
CAW14392Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER