# RANCHO CORDOVA SURGERY CENTER, LLC

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

## Provider details

- **NPI number:** 1124439419
- **Authorized official:** DR. ROMEL E VELASTEGUI M.D. (MANAGER/MEMBER)
- **Authorized official phone:** (916) 400-4038

## Contact information

- **Practice address:** 2893 SUNRISE BLVD STE 103, RANCHO CORDOVA, CA 95742-6527
- **Practice address phone:** (916) 400-4038
- **Practice address fax:** (916) 400-4391
- **Mailing address:** 2893 SUNRISE BLVD STE 103, RANCHO CORDOVA, CA 95742-6527
- **Mailing address phone:** (916) 400-4038
- **Mailing address fax:** (916) 400-4391

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/08/2014
- **Last updated:** 05/08/2014