Healthcare Provider Details

I. General information

NPI: 1285872945
Provider Name (Legal Business Name): MONTEREY PENINSULA SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2009
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 MUNRAS AVENUE, SUITE 100 SUITE 100
MONTEREY CA
93940
US

IV. Provider business mailing address

9699 BLUE LARKSPUR LN STE 202
MONTEREY CA
93940-6552
US

V. Phone/Fax

Practice location:
  • Phone: 831-372-2169
  • Fax:
Mailing address:
  • Phone: 831-372-2169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CARRIE MILLSAP
Title or Position: CEO
Credential: BSN
Phone: 831-372-2169