Healthcare Provider Details
I. General information
NPI: 1285685743
Provider Name (Legal Business Name): SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2006
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
210 CANAL ST
KING CITY CA
93930-3432
US
IV. Provider business mailing address
210 CANAL ST
KING CITY CA
93930-3432
US
V. Phone/Fax
- Phone: 831-385-5471
- Fax: 831-385-5940
- Phone: 831-385-5471
- Fax: 831-385-5940
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RENA
SALAMACHA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 831-385-7284