Healthcare Provider Details

I. General information

NPI: 1336389600
Provider Name (Legal Business Name): SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2009
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 BROADWAY ST STE. D
KING CITY CA
93930-3303
US

IV. Provider business mailing address

300 CANAL ST
KING CITY CA
93930-3431
US

V. Phone/Fax

Practice location:
  • Phone: 831-386-7437
  • Fax: 831-385-7188
Mailing address:
  • Phone: 831-386-7437
  • Fax: 831-385-7188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: RENA SALAMACHA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 831-385-7284