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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
11480 BROOKSHIRE AVE, SUITE 110, DOWNEY, CA 90241
(562) 630-3111
(562) 630-3107
Mailing address
3300 E SOUTH ST STE 308, LAKEWOOD, CA 90805-4598
(562) 630-3111
(562) 630-3107

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0093373
CA
Enumeration date
03/13/2007
Last updated
07/08/2024
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