Organization
SRS-SAN DIEGO LLC
Active
Other names
SRS-Chula Vista LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME SEYMOUR TANNENBAUM MD, PHD (CEO)
(615) 467-0140
Entity
Organization
Contact information
Practice address
963 LANE AVE, CHULA VISTA, CA 91914-3501
(855) 474-7365
(855) 631-0206
Mailing address
PO BOX 198813, NASHVILLE, TN 37219-8813
(615) 988-1060
(855) 631-0206
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
03/16/2020
Last updated
03/10/2021
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