Healthcare Provider Details

I. General information

NPI: 1093015992
Provider Name (Legal Business Name): LAUREN NASH FARAC MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN NASH FRIZZELL MD

II. Dates (important events)

Enumeration Date: 10/25/2010
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23625 HOLMAN HIGHWAY
MONTEREY CA
93940-5902
US

IV. Provider business mailing address

100 WILSON RD STE 100
MONTEREY CA
93940-7885
US

V. Phone/Fax

Practice location:
  • Phone: 831-624-5311
  • Fax:
Mailing address:
  • Phone: 831-242-8301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA129635
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: