# MARIAM S AMIRI D P M PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LOMA LINDA AMBULATORY SURGICAL CTR
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376258038
- **Authorized official:** DR. MARIAM AMIRI DPM (OWNER)
- **Authorized official phone:** (909) 522-7413

## Contact information

- **Practice address:** 11332 MOUNTAIN VIEW AVE STE A, LOMA LINDA, CA 92354-3854
- **Practice address phone:** (951) 314-3088
- **Practice address fax:** (951) 379-5310
- **Mailing address:** 11332 MOUNTAIN VIEW AVE STE A, LOMA LINDA, CA 92354-3854
- **Mailing address phone:** (951) 314-3088
- **Mailing address fax:** (951) 379-5310

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/17/2023
- **Last updated:** 06/15/2023