Organization
SOUTHLAND RENAL MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORA FISCHMAN (COO)
(562) 630-3111
Entity
Organization
Contact information
Practice address
1045 ATLANTIC AVE, SUITE 902, LONG BEACH, CA 90813-3408
(562) 630-3111
Mailing address
3300 E SOUTH ST STE 308, LAKEWOOD, CA 90805-4598
(562) 630-3111
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A46344
CA
Other
Enumeration date
10/05/2007
Last updated
12/02/2019
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