# GRANITE BAY SURGERY CENTER, LLC

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

## Provider details

- **NPI number:** 1245774611
- **Authorized official:** JOSEPH RUDY COSCIA M.D. (PARTNER)
- **Authorized official phone:** (916) 929-1833

## Contact information

- **Practice address:** 8723 SIERRA COLLEGE BLVD \#1, ROSEVILLE, CA 95661
- **Practice address phone:** (916) 773-5559
- **Mailing address:** 8723 SIERRA COLLEGE BLVD. BUILDING 1., GRANITE BAY, CA 95746

## Taxonomy

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

## Other

- **Enumeration date:** 12/05/2016
- **Last updated:** 08/28/2018