Provider Demographics
NPI:1811188188
Name:SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL
Other - Org Name:GEORGE L. MEE MEMORIAL KING CITY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:G
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-385-7233
Mailing Address - Street 1:210 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:KING CITY
Mailing Address - State:CA
Mailing Address - Zip Code:93930-3432
Mailing Address - Country:US
Mailing Address - Phone:831-385-5471
Mailing Address - Fax:831-385-5940
Practice Address - Street 1:210 CANAL ST
Practice Address - Street 2:
Practice Address - City:KING CITY
Practice Address - State:CA
Practice Address - Zip Code:93930-3432
Practice Address - Country:US
Practice Address - Phone:831-385-5471
Practice Address - Fax:831-385-5940
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARHM18562FMedicaid