Provider Demographics
NPI:1285872945
Name:MONTEREY PENINSULA SURGERY CENTER MUNRAS AVE
Entity type:Organization
Organization Name:MONTEREY PENINSULA SURGERY CENTER MUNRAS AVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGIMACHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-372-2169
Mailing Address - Street 1:665 MUNRAS AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3136
Mailing Address - Country:US
Mailing Address - Phone:831-372-2169
Mailing Address - Fax:
Practice Address - Street 1:665 MUNRAS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3134
Practice Address - Country:US
Practice Address - Phone:831-372-2169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical