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Direct Primary Care
Family Medicine

Monarch Primary Care

Quick Facts

Membership Price RangeAges 14-20: $99/month | Ages 21+: $125/month | Children Under 18 (of current patients): $80/month | Employees: $100/month
Practice TypeDirect Primary Care
DoctorsNoel Ales DO, Internal Medicine, Farnaz Pirayesh DO, Family Medicine
Panel Size450 patients per doctor
Telehealth TypeTelemedicine / televisit
HousecallsYes
Telehealth AvailableYes

About

At Monarch Primary Care, two physicians deliver membership-based direct primary care in San Luis Obispo, California. Dr. Farnaz Pirayesh founded the practice in 2023 and serves as its medical director. Dr. Noel Ales brings nearly two decades of internal medicine experience to the team. The practice caps its panel at 450 patients. Appointments run 45 minutes on average, and the team guarantees same-day or next-day availability. Members receive 24/7 personal doctor access, wholesale medications, and discounted labs and imaging. Clinical services span family medicine, women's and men's health, pediatrics, sports and back injuries, and weight loss. The practice also offers osteopathic manipulation, Emsella pelvic floor treatment, aesthetic injectables, and house calls. Teen and young adult care is a dedicated focus area.

Details

Address

865 Aerovista Place, Suite 130, San Luis Obispo, CA 93401

Membership

$125/monthly

Membership Details

Monthly membership fee covers no rushed visits, 24/7 personal doctor access, wholesale medication (adult tiers), discounted labs & imaging. Children under 18 plan available for children of current patients. Separate weight loss packages available for members and non-members.

Typical Appointment

45 minutes

Telemedicine
House Calls
Same-Day Appointments
Max 450 patients per doctor

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Frequently Asked Questions

Adults 21 and older pay $125 per month. Individuals ages 14 to 20 pay $99 per month. Children under 18 who belong to a current member's household pay $80 per month. Employee memberships are available at $100 per month. Each membership tier includes 24/7 personal doctor access, no-rush visits, discounted labs and imaging, and wholesale medications for eligible tiers.

Yes. Monarch Primary Care does not accept insurance for office care, but your existing insurance continues to work at other providers, hospitals, and pharmacies. The practice recommends maintaining a high-deductible or cost-sharing plan to cover hospitalizations, complex procedures, and emergencies.

Yes. Monarch Primary Care guarantees same-day or next-day appointments. The practice also offers telemedicine visits and house calls for added flexibility.

Appointments typically run 45 minutes. The practice schedules visits in the 30-to-60-minute range, giving the physicians time to address your full health picture without rushing.

Yes. The practice makes house calls within a 30-mile radius of San Luis Obispo. Visits within 15 miles cost $80, and visits within 30 miles cost $140.

Yes. Monarch Primary Care offers weight loss packages for both members and non-members. The program uses FDA-approved medications Wegovy (semaglutide) and Zepbound (tirzepatide). Each package includes the medication, labs to monitor progress, and monthly in-person or telehealth check-ins. Member pricing starts at $150 for semaglutide and $350 for tirzepatide.

The practice offers Botox, Sculptra, RHA fillers, Radiesse, Juvederm Voluma XC, and DermaPeel chemical peels. 50 per unit, with a lower rate for members or purchases over 50 units. Financing through Cherry is available for aesthetic services.

Yes, with conditions. Members who cancel can re-enroll on a space-available basis, subject to an $85 re-enrollment fee. The practice does not accept a third re-enrollment. Members can cancel at any time with 30 days' notice.

Yes. Teen and young adult care is a dedicated focus at the practice. A membership tier priced at $99 per month serves patients ages 14 to 20, and the clinical team actively supports this age group for primary and preventive care.

No. Monarch Primary Care does not manage chronic opioid medications or chronic benzodiazepine prescriptions. Patients who require ongoing management of these medications should work with a specialist who handles that scope of care.

Practice last updated June 11, 2026