MEDICARE: GALILEO SURGERY CENTER, LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CB235712	OTHER	CA	MEDICARE PTAN
3	S051448	OTHER	CA	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396748547
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GALILEO SURGERY CENTER, LP

Provider Business Mailing Address
First Line	:	PO BOX 5458
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93403-5458
Country	:	US
Telephone Number	:	805-786-4878
Fax Number	:	805-597-8350

Provider Business Practice Location Address
First Line	:	1001 E FOOTHILL BLVD
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93405-1815
Country	:	US
Telephone Number	:	805-782-8222
Fax Number	:	805-782-8220

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	MR. BORIS I PILCH
Credential	:	MD
Telephone Number	:	805-597-8370

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/06/2022

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Directions to “GALILEO SURGERY CENTER, LP ” Practice Location

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