Healthcare Provider Details

I. General information

NPI: 1508842873
Provider Name (Legal Business Name): MONTEREY PENINSULA URGENT CARE MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 WASHINGTON ST
MONTEREY CA
93940-2409
US

IV. Provider business mailing address

245 WASHINGTON ST
MONTEREY CA
93940-2409
US

V. Phone/Fax

Practice location:
  • Phone: 831-372-2273
  • Fax: 831-372-5840
Mailing address:
  • Phone: 831-372-2273
  • Fax: 831-372-5840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: RUBY STANLEY-COHAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 831-372-2273