Basic Information
| Provider Information | |||||||||
| NPI: | 1932197258 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX HH | ||||||||
| Address2: | BUSINESS DEVELOPMENT & CONTRACTING | ||||||||
| City: | MONTEREY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939426032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316583977 | ||||||||
| FaxNumber: | 8316583978 | ||||||||
| Practice Location | |||||||||
| Address1: | 23625 WR HOLMAN HWY | ||||||||
| Address2: | |||||||||
| City: | MONTEREY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939405902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316245311 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2005 | ||||||||
| LastUpdateDate: | 02/23/2022 | ||||||||
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| AuthorizedOfficialLastName: | MORGAN | ||||||||
| AuthorizedOfficialFirstName: | MATTHEW | ||||||||
| AuthorizedOfficialMiddleName: | THOMAS | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8316254965 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 0700000026 | CA | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | HSP40145F | 05 | CA | MEDICAID | ZZR00145F | 05 | CA | MEDICAID |