Basic Information
| Provider Information | |||||||||
| NPI: | 1649210212 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MONTEREY DOCTORS SURGERY CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 665 MUNRAS AVE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | MONTEREY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939403134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316426200 | ||||||||
| FaxNumber: | 8316426202 | ||||||||
| Practice Location | |||||||||
| Address1: | 665 MUNRAS AVE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | MONTEREY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939403134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316426200 | ||||||||
| FaxNumber: | 8316426202 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | SMITH | ||||||||
| AuthorizedOfficialFirstName: | SHANNON | ||||||||
| AuthorizedOfficialMiddleName: | MARIE | ||||||||
| AuthorizedOfficialTitleorPosition: | FINANCIAL ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 4158854400 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | CPA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | CA | N | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical | 261QA1903X | 070000607 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.