# BOLT SURGERY CENTER, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1649823964
- **Authorized official:** KENNA MORGAN (NURSE MANAGER)
- **Authorized official phone:** (928) 486-6004

## Contact information

- **Practice address:** 1124 S MAIN ST STE 102, CORONA, CA 92882-4449
- **Practice address phone:** (928) 486-6004
- **Mailing address:** 1124 S MAIN ST STE 102, CORONA, CA 92882-4449

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/17/2019
- **Last updated:** 07/17/2019