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Organization
SOUTHLAND RENAL MEDICAL GROUP, INC.
Active
Organization
SOUTHLAND RENAL MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AVEDIK SEMERJIAN MD, FACP, FASN (PRESIDENT)
(562) 630-3111
Entity
Organization
Contact information
Practice address
3300 E. SOUTH STREET, SUITE 308, LONG BEACH, CA 90805-4598
(562) 630-3111
(562) 630-3107
Mailing address
PO BOX 879, LAKEWOOD, CA 90714-0879
(562) 630-3111
(562) 630-3107
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A46344
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0093370
—
CA
Enumeration date
07/05/2006
Last updated
07/08/2024
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