# CONCIERGE SURGICAL CENTER

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

## Provider details

- **NPI number:** 1972038818
- **Authorized official:** MR. SHAUN LEA CRNA (CRNA)
- **Authorized official phone:** (805) 474-6383

## Contact information

- **Practice address:** 860 OAK PARK BLVD, STE 102, ARROYO GRANDE, CA 93420-1800
- **Practice address phone:** (805) 474-6383
- **Mailing address:** 860 OAK PARK BLVD, STE 301, ARROYO GRANDE, CA 93420-1800
- **Mailing address phone:** (805) 474-6383

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 57590 | CA | Yes |

## Other

- **Enumeration date:** 04/28/2017
- **Last updated:** 12/20/2017