Organization
GREENBRAE SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT G. AYCOCK M.D. (OWNER, MEDICAL DIRECTOR)
(415) 925-8900
Entity
Organization
Contact information
Practice address
575 SIR FRANCIS DRAKE BLVD, SUITE 3, GREENBRAE, CA 94904-2307
(415) 925-8900
(415) 925-8908
Mailing address
575 SIR FRANCIS DRAKE BLVD, SUITE 3, GREENBRAE, CA 94904-2307
(415) 925-8900
(415) 925-8908
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
2244
CA
261QA1903X
Ambulatory Surgical Clinic/Center
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Other
Enumeration date
05/01/2008
Last updated
08/07/2012
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