Organization
SRS-LA HABRA
Active
Other names
SRS-LA HABRA, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME S TANNENBAUM MD,PHD (CEO)
(615) 467-0140
Entity
Organization
Contact information
Practice address
1611 W WHITTIER BLVD, LA HABRA, CA 90631
(615) 988-7881
(855) 631-0206
Mailing address
4230 HARDING PIKE, STE 205, NASHVILLE, TN 37205-2098
(615) 988-7881
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
06/26/2023
Last updated
12/12/2023
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