Provider Demographics
NPI:1740419837
Name:SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL
Other - Org Name:GEORGE L. MEE MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:WANGSMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-385-7160
Mailing Address - Street 1:300 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:KING CITY
Mailing Address - State:CA
Mailing Address - Zip Code:93930-3431
Mailing Address - Country:US
Mailing Address - Phone:831-385-6000
Mailing Address - Fax:831-385-7188
Practice Address - Street 1:300 CANAL ST
Practice Address - Street 2:
Practice Address - City:KING CITY
Practice Address - State:CA
Practice Address - Zip Code:93930-3431
Practice Address - Country:US
Practice Address - Phone:831-385-6000
Practice Address - Fax:831-385-7188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070000047282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZC2705ZOtherBLUE SHIELD - MMH FACILITY CHARGES