# PALM BLUFFS SURGERY CENTER LLC

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

## Provider details

- **NPI number:** 1316674518
- **Authorized official:** DR. JORDAN DAVID PRIETO DDS (OWNER)
- **Authorized official phone:** (559) 906-0209

## Contact information

- **Practice address:** 7766 N PALM AVE \# 104, FRESNO, CA 93711-5734
- **Practice address phone:** (559) 439-5300
- **Mailing address:** 7766 N PALM AVE STE 104, FRESNO, CA 93711-5704
- **Mailing address phone:** (559) 439-5300
- **Mailing address fax:** (559) 412-2645

## Taxonomy

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

## Other

- **Enumeration date:** 08/07/2022
- **Last updated:** 04/02/2025