Organization
PACIFIC SURGERY CENTER OF SAN LUIS OBISPO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE TUASON RN (DIRECTOR OF NURSING)
(818) 348-7246
Entity
Organization
Contact information
Practice address
4472 BROAD ST STE 150, SAN LUIS OBISPO, CA 93401-7990
(818) 348-7246
Mailing address
7230 MEDICAL CENTER DR STE 500, WEST HILLS, CA 91307-4024
(818) 348-7246
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
03/10/2025
Last updated
03/10/2025
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