# MONTEREY PENINSULA URGENT CARE MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508842873
- **Authorized official:** RUBY STANLEY-COHAN (ADMINISTRATOR)
- **Authorized official phone:** (831) 372-2273

## Contact information

- **Practice address:** 245 WASHINGTON ST, MONTEREY, CA 93940-2409
- **Practice address phone:** (831) 372-2273
- **Practice address fax:** (831) 372-5840
- **Mailing address:** 245 WASHINGTON ST, MONTEREY, CA 93940-2409
- **Mailing address phone:** (831) 372-2273
- **Mailing address fax:** (831) 372-5840

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | CA | Yes |

## Other

- **Enumeration date:** 12/19/2005
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00361660 | BC/BS | CA |
| 01 | — | 00C361660 | CHAMPUS | CA |
| 01 | — | 00C433710 | BC/BS | CA |
| 01 | — | 00G588151 | BC/BS | CA |
| 01 | — | 77047127 | TAX ID | CA |
| 01 | — | C36166 | STATE LICENSE | CA |
| 01 | — | C43371 | STATE LICENSE | CA |
| 01 | — | G58815 | STATE LICENSE | CA |