GRANITE BAY SURGERY CENTER, LLC (NPI# 1245774611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245774611 |
| Entity Type | Organization |
| Organization Name | GRANITE BAY SURGERY CENTER, LLC |
| Practice Address |
8723 Sierra College Blvd #1 Roseville CA 95661 |
| Mailing Address |
8723 Sierra College Blvd. Building 1. Granite Bay CA 95746 |
| Practice Telephone | 9167735559 |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2018-08-28 |
| Authorized Official Name | JOSEPH RUDY COSCIA (PARTNER) |
| Authorized Official Telephone | 9169291833 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
CA | Ambulatory Health Care Facilities |
| Street Address |
8723 SIERRA COLLEGE BLVD #1 |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134777816 | Aprildawn Mccarty Mccarty | Behavior Technician | 2125 Professional Dr, 100, Roseville, CA 95661 | 2019-08-27 |
| 1407409089 | David Armel Gomez Croddy | Dentist | 2740 Carradale Drive, Roseville, CA 95661 | 2019-07-22 |
| 1699335612 | Mowell | Durable Medical Equipment & Medical Supplies | 901 Sunrise, Roseville, CA 95661 | 2019-06-20 |
| 1578024998 | Mystesia Lasan Hayes | Behavior Technician | 4121 Vittorio Dr., Roseville, CA 95661 | 2019-03-28 |
| 1033676457 | The Place Within | Counselor | 720 Sunrise Ave #d115, Roseville, CO 95661 | 2019-02-21 |
| 1396217733 | Tuyen Thi Thanh Nguyen | Respiratory Therapist, Registered | Kaiser Roseville Hospital, 1600 Eureka Rd, Roseville, CA 95661 | 2018-12-26 |
| 1982179776 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 1565 Eureka Road, Suite 5, Roseville, CA 95661 | 2018-10-08 |
| 1184106536 | Sabita Kondle | Marriage & Family Therapist | 1528 Hope Counseling Center Ste 101, Roseville, CA 95661 | 2018-09-02 |
| 1740787837 | Sylvia A Atieno | Nurse Practitioner | Suttter Roseville Medical Center, 1 Medical Plaza, Roseville, CA 95661 | 2018-04-06 |
| 1457875296 | Good Works Psychophysiology and Physical Therapy | Physical Therapist | 1650 Leadhill Blvd, 600, Roseville, CA 95661 | 2017-08-02 |
| Find all providers in zip 95661 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689695314 | Lee Institute of Plastic Surgery | Clinic/Center | 5 Medical Plaza Drive, Suite 210, Roseville, CA 95661 | 2006-07-21 |
| 1982672283 | Roseville Surgery Center, Lp | Clinic/Center | 1420 E Roseville Pkwy, Ste 100, Roseville, CA 95661-3078 | 2006-03-10 |
| 1467451096 | South Placer Surgery Center Lp | Clinic/Center | 8 Medical Plaza Drive, Suite 100, Roseville, CA 95661-2185 | 2005-07-15 |
| 1144482092 | Roseville Surgical Alliance Surgery Center, Inc. | Clinic/Center | 5 Medical Plaza Drive, Suite 120, Roseville, CA 95661 | 2008-07-01 |
| 1144497264 | California Skin Surgery Center Inc | Clinic/Center | 9269 Sierra College Blvd, Roseville, CA 95661 | 2008-05-08 |
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|---|---|---|---|---|
| 1790384303 | Abroms Dougherty Vision Asc LLC | Clinic/Center | 4472 Broad St Ste 150, San Luis Obispo, CA 93401-7933 | 2020-10-23 |
| 1861091993 | Willow Vista Surgical Center | Clinic/Center | 39810 Portola Ave, Palm Desert, CA 92260-0624 | 2020-10-20 |
| 1366041469 | The Regents of The University of California | Clinic/Center | 4343 Lankershim Blvd Ste 210, North Hollywood, CA 91602-2705 | 2020-10-20 |
| 1609473420 | Alden Advanced Surgicenter LLC | Clinic/Center | 8741 Alden Drive, Suite B, Los Angeles, CA 90048 | 2020-10-05 |
| 1396352944 | Irvine Surgical Center LLC | Clinic/Center | 17624 Redhill Ave Ste B, Irvine, CA 92614 | 2020-09-28 |
| 1538775267 | Ev Surgery Institute LLC | Clinic/Center | 105 N Bascom Ave Ste 105, San Jose, CA 95128-1811 | 2020-09-18 |
| 1003420001 | On Beach Surgery Center, LLC | Clinic/Center | 5832 Beach Blvd, Suite 210, Buena Park, CA 90621 | 2020-09-07 |
| 1811501661 | Precision Surgical Arts | Clinic/Center | 20311 Sw Birch St Ste 201, Newport Beach, CA 92660-1777 | 2020-08-31 |
| 1205448750 | Elite Surgery Center of South Bay LLC | Clinic/Center | 20528 Hawthorne Blvd Ste 301, Torrance, CA 90503-3202 | 2020-08-17 |
| 1740891571 | Peninsula Surgery Center, LLC | Clinic/Center | 350 Marine Pkwy Ste 100, Redwood City, CA 94065-5224 | 2020-08-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.