Organization
SRS-LOS NIETOS
Active
Other names
SRS-LOS NIETOS, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME S TANNENBAUM MD, PH.D. (CEO)
(615) 467-0140
Entity
Organization
Contact information
Practice address
10012 NORWALK BLVD. STE 190, SANTA FE SPRINGS, CA 90670
(615) 988-7881
Mailing address
4230 HARDING PIKE, SUITE 205, NASHVILLE, TN 37205-2098
(615) 467-0140
(855) 631-0206
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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