Organization
PACIFIC SURGERY CENTER OF SAN LUIS OBISPO, LLC
Active
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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