Organization
SRS-LA MIRADA LLC
Active
Organization
SRS-LA MIRADA LLC
Active
Other names
SRS-LA MIRADA, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME TANNENBAUM MD (CEO)
(615) 467-0140
Entity
Organization
Contact information
Practice address
14337 IMPERIAL HWY, LA MIRADA, CA 90638
(615) 988-7881
Mailing address
4230 HARDING PIKE, SUITE 205, NASHVILLE, TN 37205-2098
(615) 467-0140
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
01/01/2024
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