1306952908 NPI number — LAS VENTANAS SURGERY CENTER

Table of content: CAREY RAE HOEFT MS (NPI 1023464070)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306952908 NPI number — LAS VENTANAS SURGERY CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAS VENTANAS SURGERY CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306952908
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15 RYAN CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONTEREY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93940-7866
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
183-775-0265
Provider Business Mailing Address Fax Number:
831-775-0270

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 RYAN CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONTEREY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93940-7866
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
183-775-0265
Provider Business Practice Location Address Fax Number:
831-775-0270
Provider Enumeration Date:
08/23/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ANDRADE
Authorized Official First Name:
ERICA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF NURSING
Authorized Official Telephone Number:
831-775-0265

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  070000682 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)