SOUTHLAND RENAL MEDICAL GROUP, INC. (NPI# 1205969748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205969748 |
| Entity Type | Organization |
| Organization Name | SOUTHLAND RENAL MEDICAL GROUP, INC. |
| Practice Address |
3851 Katella Ave Suite 155 Los Alamitos CA 90720 |
| Mailing Address |
3300 E. South Street Suite 308 Long Beach CA 90805-4598 |
| Practice Telephone | 5626303111 |
| Practice Fax Number | 5626303107 |
| Mailing Telephone | 5626303111 |
| Mailing Fax Number | 5626303107 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2018-08-15 |
| Authorized Official Name | AVEDIK SEMERJIAN (SECRETARY) |
| Authorized Official Telephone | 5626303111 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHLAND RENAL MEDICAL GROUP, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
A46344 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0093371 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730110495 | Southland Renal Medical Group, Inc. | Internal Medicine | 3300 E. South Street, Suite 308, Long Beach, CA 90805-4598 | 2006-07-05 |
| Street Address |
3851 KATELLA AVE SUITE 155 |
| City | LOS ALAMITOS |
| State | CA |
| Zip Code | 90720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194722611 | Stanley K Chou | Acupuncturist | 3851 Katella Ave, Suite 301, Los Alamitos, CA 90720-3309 | 2005-06-30 |
| 1538606330 | Beach Orthopaedic Specialty Institute Inc | Orthopaedic Surgery | 3851 Katella Ave, Suite 202, Los Alamitos, CA 90720-3309 | 2017-01-31 |
| 1720436918 | Christopher J Woodson Md | Orthopaedic Surgery | 3851 Katella Ave, # 375, Los Alamitos, CA 90720-3309 | 2016-05-27 |
| 1114398617 | Socal Medical Specialist Medical Corporation | Orthopaedic Surgery | 3851 Katella Ave, Suite 150, Los Alamitos, CA 90720-3309 | 2015-10-12 |
| 1285004028 | Kathryn Walker | Marriage & Family Therapist | 3851 Katella Ave, Los Alamitos, CA 90720-3309 | 2015-10-06 |
| 1295104354 | Matt Reza Khoshnevis Md A Professional Corporation | Internal Medicine | 3851 Katella Ave, Suite 315, Los Alamitos, CA 90720-3309 | 2015-09-18 |
| 1700262748 | Mili Shah | Dentist | 3851 Katella Ave, Suite 225, Los Alamitos, CA 90720-3309 | 2015-07-31 |
| 1396137568 | Orange County Urgent Care #3 Inc. | Clinic/Center | 3851 Katella Ave, Suite 100, Los Alamitos, CA 90720-3309 | 2015-02-25 |
| 1679976906 | Michael Fishman Dpm Inc | Podiatrist | 3851 Katella Ave, Suite 355, Los Alamitos, CA 90720-3377 | 2014-10-01 |
| 1730502360 | Dr Lousine Melik-adamyan Inc | Internal Medicine | 3851 Katella Ave, Suite #315, Los Alamitos, CA 90720-3338 | 2014-02-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871152132 | Connie Lee Wax | Social Worker | 5182 Katella, Suite 206, Los Alamitos, CA 90720 | 2019-06-11 |
| 1750891446 | Angela Lynn Hudson | Nurse Practitioner | 4281 Katella Ave Ste 215, Los Alamitos, CA 90720 | 2017-10-06 |
| 1922524149 | Tigom LLC | Pharmacy | 4434 Cerritos Ave, Los Alamitos, CA 90720 | 2017-08-18 |
| 1821531401 | Added Access Cardiology Inc | Internal Medicine | 3801 Katella Ave Suite 401, Los Alamitos, CA 90720 | 2016-11-30 |
| 1619348091 | Debbie Chen | Marriage & Family Therapist | 5182 Katella Ave Ste 202, Los Alamitos, CA 90720 | 2015-10-12 |
| 1801292974 | Michelle R. Ancharoff | Psychologist | 4281 Katella Ave #122, Los Alamitos, CA 90720 | 2014-11-17 |
| 1497179253 | Jeffrey J Mccullough | Dentist | 4281 Katella Ave Ste 112, Los Alamitos, CA 90720 | 2014-02-13 |
| 1043634124 | Alamitos Oral Surgery | Dentist | 4582 Katella Avenue, Los Alamitos, CA 90720 | 2014-02-11 |
| 1972939718 | Twin Town Corporation | Clinic/Center | 4376 Katella Ave., Los Alamitos, CA 90720 | 2013-09-25 |
| 1952644197 | Lindsay Enebak Mossinger | Internal Medicine | 3851 Katella Ave Ste 220, Los Alamitos, CA 90720 | 2013-04-05 |
| Find all providers in zip 90720 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942463427 | Meenakshi Verma | Internal Medicine | 10861 Cherry St Ste 104, Los Alamitos, CA 90720-5403 | 2008-07-06 |
| 1972637890 | Prohealth Partners A Medical Group | Internal Medicine | 3851 Katella Ave Ste 325, Los Alamitos, CA 90720-3574 | 2007-03-15 |
| 1114151958 | Medicine and Nephrology Associates | Internal Medicine | 10941 Bloomfield St, Suite A, Los Alamitos, CA 90720-2530 | 2009-05-07 |
| 1649454638 | Tanzina Nasreen | Internal Medicine | 10941 Bloomfield St, Suite A, Los Alamitos, CA 90720-2530 | 2007-12-26 |
| 1215129523 | Jack Rubin Md, A Prof Corporation | Internal Medicine | 10941 Bloomfield St, Los Alamitos, CA 90720-2530 | 2007-08-10 |
| 1285752436 | Sheida A Kashani | Internal Medicine | 3751 Katella Ave, Los Alamitos, CA 90720-3113 | 2007-03-27 |
| 1053408435 | Ing L Wong | Internal Medicine | 3801 Katella Ave, Ste 225, Los Alamitos, CA 90720 | 2006-10-06 |
| 1518954973 | Heena M Contractor | Internal Medicine | 10941 Bloomfield St, #a, Los Alamitos, CA 90720-2530 | 2005-09-30 |
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| 1629600416 | Valley Kidney Medical Group Inc | Internal Medicine | 1646 E Herndon Ave Ste 106, Fresno, CA 93720-3380 | 2020-02-10 |
| 1437789278 | Spectrum Dialysis | Internal Medicine | 18040 Sherman Way Ste 220, Reseda, CA 91335-4631 | 2020-01-21 |
| 1932745007 | K Care Ipa | Internal Medicine | 18000 Studebaker Rd Ste 100, Cerritos, CA 90703-7929 | 2019-11-22 |
| 1326609496 | Alliance Hospitalist Medical Corporation | Internal Medicine | 3300 E South St Ste 307, Lakewood, CA 90805 | 2019-06-27 |
| 1669930723 | Adventist Health Physicians Network | Internal Medicine | 111 Raley Blvd Ste 160, Chico, CA 95928-8351 | 2019-03-07 |
| 1295293363 | Adventist Health Physicians Network | Internal Medicine | 111 Raley Blvd Ste 220, Chico, CA 95928-8351 | 2019-03-07 |
| Find all providers with the same taxonomy | ||||
| City | LOS ALAMITOS |
| Zip Code | 90720 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.