GREENBRAE SURGERY CENTER LLC NPI 1518133321

NPI Information

  • NPI: 1518133321
  • Provider Name: GREENBRAE SURGERY CENTER LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 05D1021721
  • Address: 575 SIR FRANCIS DRAKE BLVD
    SUITE 3
    GREENBRAE, CA
    ZIP 94904
  • Phone: (415) 925-8900

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NPI Details

GREENBRAE SURGERY CENTER LLC is an ambulatory surgical clinic center in Greenbrae, CA. GREENBRAE SURGERY CENTER LLC NPI is 1518133321. The provider is registered as an organization entity type.

The provider's business location address is:

575 SIR FRANCIS DRAKE BLVD
SUITE 3
GREENBRAE, CA
ZIP 94904-307
Phone: (415) 925-8900
Fax: (415) 925-8908

The provider's authorized official is Robert G. Aycock .
The authorized official title is Owner, Medical Director and has the following contact phone number (415) 925-8900.

The CLIA number assigned to this NPI record is 05D1021721 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/1/2008 and was last updated on 8/7/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory SurgicalNo
2261QA1903XClinic/CenterAmbulatory Surgical2244CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
105C1679MEDICARE PIN
205C1679MEDICARE PINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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