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Organization

GRANITE BAY SURGERY CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH RUDY COSCIA M.D. (PARTNER)
(916) 929-1833
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
CA

Other

Enumeration date
12/05/2016
Last updated
08/28/2018
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