MEDICARE: MONTEREY PENINSULA SURGERY CENTERS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	070000398	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326256058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTEREY PENINSULA SURGERY CENTERS, LLC

Provider Business Mailing Address
First Line	:	2 UPPER RAGSDALE DRIVE, BUILDING B, SUITE 160
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-5736
Country	:	US
Telephone Number	:	831-372-2169
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 UPPER RAGSDALE DRIVE, BUILDING B, SUITE 160
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-5736
Country	:	US
Telephone Number	:	831-372-2169
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. CARRIE MILLSAP
Credential	:	RN
Telephone Number	:	831-372-2169

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	12/11/2025

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