# GREENBRAE SURGERY CENTER LLC

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

## Provider details

- **NPI number:** 1518133321
- **Authorized official:** ROBERT G. AYCOCK M.D. (OWNER, MEDICAL DIRECTOR)
- **Authorized official phone:** (415) 925-8900

## Contact information

- **Practice address:** 575 SIR FRANCIS DRAKE BLVD, SUITE 3, GREENBRAE, CA 94904-2307
- **Practice address phone:** (415) 925-8900
- **Practice address fax:** (415) 925-8908
- **Mailing address:** 575 SIR FRANCIS DRAKE BLVD, SUITE 3, GREENBRAE, CA 94904-2307
- **Mailing address phone:** (415) 925-8900
- **Mailing address fax:** (415) 925-8908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 2244 | CA | Yes |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/01/2008
- **Last updated:** 08/07/2012