Provider Demographics
NPI:1508854423
Name:COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA
Entity Type:Organization
Organization Name:COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA
Other - Org Name:HOSPICE OF THE CENTRAL COAST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT, CFO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-625-4965
Mailing Address - Street 1:PO BOX HH
Mailing Address - Street 2:BUSINESS DEVELOPMENT & CONTRACTING
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93942-6032
Mailing Address - Country:US
Mailing Address - Phone:831-658-3977
Mailing Address - Fax:831-658-3978
Practice Address - Street 1:2 UPPER RAGSDALE DR
Practice Address - Street 2:STE D210
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-7850
Practice Address - Country:US
Practice Address - Phone:831-649-7750
Practice Address - Fax:831-649-7751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-13
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0700000395251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC01501GMedicaid
CAHPC01501GMedicaid