Basic Information
Provider Information
NPI: 1053648964
EntityType: 2
ReplacementNPI:  
OrganizationName: SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: GEORGE L. MEE MEMORIAL HOSPITAL
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 CANAL ST
Address2:  
City: KING CITY
State: CA
PostalCode: 939303431
CountryCode: US
TelephoneNumber: 8313856000
FaxNumber: 8313857188
Practice Location
Address1: 300 CANAL ST
Address2:  
City: KING CITY
State: CA
PostalCode: 939303431
CountryCode: US
TelephoneNumber: 8313856000
FaxNumber: 8313857188
Other Information
ProviderEnumerationDate: 11/13/2009
LastUpdateDate: 11/17/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: CHILDERS
AuthorizedOfficialFirstName: SUSAN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 8313857160
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X070000047CAY HospitalsGeneral Acute Care Hospital 

No ID Information.


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