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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