Healthcare Provider Details

I. General information

NPI: 1306169677
Provider Name (Legal Business Name): SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2010
Last Update Date: 11/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 CANAL ST STE A
KING CITY CA
93930-3461
US

IV. Provider business mailing address

400 CANAL ST STE A
KING CITY CA
93930-3461
US

V. Phone/Fax

Practice location:
  • Phone: 831-385-1280
  • Fax: 831-385-1285
Mailing address:
  • Phone: 831-385-1280
  • Fax: 831-385-1285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number070000047
License Number StateCA

VIII. Authorized Official

Name: MR. LEX SMITH
Title or Position: CEO
Credential:
Phone: 831-385-7233