Healthcare Provider Details

I. General information

NPI: 1316069545
Provider Name (Legal Business Name): MONTEREY BAY EMERGENCY PHYSICIANS MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23625 HOLMAN HWY
MONTEREY CA
93940-5902
US

IV. Provider business mailing address

7 CARIBOU CT
MONTEREY CA
93940-6303
US

V. Phone/Fax

Practice location:
  • Phone: 831-624-5311
  • Fax:
Mailing address:
  • Phone: 831-646-1940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KARL NICHOLAS
Title or Position: CFO TREASURER
Credential: M.D.
Phone: 831-646-1940