Healthcare Provider Details

I. General information

NPI: 1508704909
Provider Name (Legal Business Name): AMBULATORY SURGERY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 DEVLIN RD
NAPA CA
94558-6274
US

IV. Provider business mailing address

499 DEVLIN RD
NAPA CA
94558-6274
US

V. Phone/Fax

Practice location:
  • Phone: 707-645-7210
  • Fax: 707-645-7210
Mailing address:
  • Phone: 707-645-7210
  • Fax: 707-645-7210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH MICHAEL CENTENO
Title or Position: OWNER
Credential: MD
Phone: 415-578-8487