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General NPI Number Information
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NPI Number | 1104850312
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Entity Type | Organization
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Legal Business Name | MONTEREY PENINSULA SURGERY CENTER LLC
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 966 CASS ST STE 150
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City | MONTEREY
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State | CA
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Zip | 93940-4522
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Country | US
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Telephone | 831-372-2169
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Fax | 831-372-6323
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Provider Business Mailing Address
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Address Line | 966 CASS ST STE 150
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City | MONTEREY
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State | CA
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Zip | 93940-4522
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Country | US
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Telephone | 831-372-2169
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Fax | 831-372-6323
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Authorized Official
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Title or Position | CEO
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Name | MS. CARRIE MILLSAP
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Credential |
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Telephone | 831-372-2169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 070000398
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License Number State | CA
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