Coast Presidio Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

G22919 Issued in CA

Legal business name

COAST PRESIDIO SURGERY CENTER LLC

Practice address

225 W Pueblo St
Suite B
Santa Barbara, CA 93105-3804

Phone

(805) 682-4532

Fax

(805) 687-0724

NPI assigned

Apr 12, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Gregory S Keller, M.D.

Title

President

Phone

(805) 687-6408

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365724800000",
    "number": "1093158750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 W PUEBLO ST",
            "address_2": "SUITE B",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931053804",
            "telephone_number": "805-682-4532",
            "fax_number": "805-687-0724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 W PUEBLO ST",
            "address_2": "SUITE B",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931053804",
            "telephone_number": "805-682-4532",
            "fax_number": "805-687-0724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST PRESIDIO SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-12",
        "last_updated": "2013-04-12",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-687-6408",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "G22919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Santa Barbara, CA
• Providers in Santa Barbara, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.