Organization Name: | SURGICAL ASSOCIATES OF MONTEREY BAY MEDICAL CORPORATION |
NPI Number: | 1003985037 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENNIFER SHOUP (ADMINISTRATIVE ASSISTANT) |
Mailing Address: | 1668 Dominican Way Santa Cruz |
State: | CA US |
Postal Code: | 950651522 |
Phone Number: | 8314649962 |
Fax Number: | 8314649933 |
NPI Enumeration Date: | 11/06/2006 |
NPI Last Update Date: | 08/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2086S0129X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Surgery |
Taxonomy Specialization: | Vascular Surgery |
Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |