SRS-LA MIRADA, LLC – NPI #1538845474
Clinic/Center

SRS-LA MIRADA, LLC is an AHC clinic located in LA MIRADA, CA. NPPES has assigned the NPI number 1538845474 to SRS-LA MIRADA, LLC on June 26, 2023. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SRS-LA MIRADA, LLC” is a dba name, the actual legal business name for this organization is SRS-LA MIRADA LLC. The primary taxonomy selected by this provider is 261QE0700X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment

The NPI profile was previously updated about 2 years ago on Jan 01, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SRS-LA MIRADA, LLC below.

NPI Profile for
SRS-LA MIRADA LLC

NPI Number
1538845474
Enumeration Date

(about 3 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SRS-LA MIRADA LLC
Doing Business As (dba): SRS-LA MIRADA, LLC
Primary location
14337 IMPERIAL HWY
LA MIRADA, CA 90638
Phone: (615) 988-7881 Fax:
Mailing address
4230 HARDING PIKE
SUITE 205
NASHVILLE, TN 37205-2098
Phone: (615) 467-0140 Fax:
Organization Subpart
No
Authorized Official
JEROME TANNENBAUM
CEO
Phone: (615) 467-0140
Updated
Certification Date
Jan 01, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0700X
- Clinic/Center / End-Stage Renal Disease (ESRD) Treatment (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.