Concierge Surgical Center

Key facts

NPI

1972038818

Entity type

Organization (NPI type 2)

Primary specialty

Ambulatory Surgical Clinic/Center 261QA1903X

License

57590 (CA)

Legal business name

CONCIERGE SURGICAL CENTER

Practice address

860 Oak Park Blvd
Ste 102
Arroyo Grande, CA 93420-1800

Phone

(805) 474-6383

NPI assigned

Apr 28, 2017

Organization subpart

No

Authorized official

Name

Mr. Shaun Lea, CRNA NPI 1245570035

Title

Crna

Phone

(805) 474-6383

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shaun Michael Lea, CRNA Certified Registered Nurse Anesthetist · Bakersfield, CA · NPI 1245570035
  NPD (past) Authorized official

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 20, 2017.

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513728000000",
    "number": "1972038818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OAK PARK BLVD",
            "address_2": "STE 301",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934201800",
            "telephone_number": "805-474-6383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 OAK PARK BLVD",
            "address_2": "STE 102",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934201800",
            "telephone_number": "805-474-6383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCIERGE SURGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-28",
        "last_updated": "2017-12-20",
        "status": "A",
        "authorized_official_last_name": "LEA",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_title_or_position": "CRNA",
        "authorized_official_telephone_number": "805-474-6383",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "57590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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