Healthcare Provider Details

I. General information

NPI: 1316086507
Provider Name (Legal Business Name): MONTEREY BAY SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3275 APTOS RANCHO ROAD UNIT A
APTOS CA
95003
US

IV. Provider business mailing address

3275 APTOS RANCHO ROAD UNIT A
APTOS CA
95003
US

V. Phone/Fax

Practice location:
  • Phone: 831-662-3890
  • Fax: 831-662-3289
Mailing address:
  • Phone: 831-662-3890
  • Fax: 831-662-3289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberZZZ268082
License Number StateCA

VIII. Authorized Official

Name: CHRISTOPHER SUMMA
Title or Position: MD MEDICAL DIRECTOR
Credential: MD
Phone: 831-662-3890