SRS-CRESCENT CITY, LLC (NPI# 1376074559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376074559 |
| Entity Type | Organization |
| Organization Name | SRS-CRESCENT CITY, LLC |
| Practice Address |
780 E Washington Blvd Building B Crescent City CA 95531-8397 |
| Mailing Address |
Po Box 198813 Nashville TN 37219-8397 |
| Practice Telephone | 6154670140 |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2017-03-30 |
| Authorized Official Name | DR. JEROME TANNENBAUM (CEO) |
| Authorized Official Telephone | 6154670140 |
| Authorized Official Credential | MD, PHD, FACP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| Street Address |
780 E WASHINGTON BLVD BUILDING B |
| City | CRESCENT CITY |
| State | CA |
| Zip Code | 95531-8397 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720033889 | Tien Huy Nguyen | Surgery | 780 E Washington Blvd, Suite 105, Crescent City, CA 95531-8397 | 2006-05-24 |
| 1376909606 | Sutter Coast Hospital | Orthopaedic Surgery | 780 E Washington Blvd, Suite 105, Crescent City, CA 95531-8397 | 2015-12-31 |
| 1134381536 | Elie M Hobeika | Obstetrics & Gynecology | 780 E Washington Blvd, Ste 202, Crescent City, CA 95531-8397 | 2008-06-26 |
| 1902065279 | Carla Nelson | Pediatrics | 780 E Washington Blvd, Ste 202, Crescent City, CA 95531-8397 | 2008-06-03 |
| 1699965228 | Nabil Elkhoury | Obstetrics & Gynecology | 780 E Washington Blvd, Suite 101, Crescent City, CA 95531-8397 | 2007-07-30 |
| 1255415626 | Margo M Pfunder | Advanced Practice Midwife | 780 E Washington Blvd, Suite 202, Crescent City, CA 95531-8397 | 2006-10-24 |
| 1700960267 | Sutter Coast Hospital | General Practice | 780 E Washington Blvd, Suite 202, Crescent City, CA 95531-8397 | 2006-10-24 |
| 1083627517 | Susan Brallier | Pediatrics | 780 E Washington Blvd, Ste 202, Crescent City, CA 95531-8397 | 2006-08-14 |
| 1548288491 | Jai Chand Autar | Specialist | 780 E Washington Blvd, Suite 202, Crescent City, CA 95531-8397 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548725237 | John Michael Horner | Counselor | 455 Kst, Crescent City, CA 95531 | 2019-02-06 |
| 1245716943 | Tonya Shantel Escobar | Registered Nurse | 1301b Northcrest Drive #13, Crescent City, CA 95531 | 2018-07-16 |
| 1679019319 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 657 Hwy 101 N, Crescent City, CA 95531 | 2017-01-18 |
| 1063969558 | Darrick Stewart Roach | Massage Therapist | 1225 Marshall St., 18, Crescent City, CA 95531 | 2016-09-01 |
| 1447638044 | Yelena Zaitseva Lavender | Counselor | 455 K Street, Crescent City, CA 95531 | 2015-05-14 |
| 1942630421 | Kamilia Ann Schnacker | Counselor | 370 9th Street, Crescent City, CA 95531 | 2013-11-19 |
| 1881906261 | Peter Allen Brown | Psychologist | 505 H Street, Crescent City, CA 95531 | 2010-07-13 |
| 1700119385 | Remi Vista Services for Probation Youth | Community/Behavioral Health | 206 Williams Dr # 2, Crescent City, CA 95531 | 2009-09-14 |
| 1982862538 | Joshua Thomas Matson | Chiropractor | 550 E Washington Blvd Ste 100, Crescent City, CA 95531 | 2008-05-30 |
| 1902076250 | County of Del Norte | Community/Behavioral Health | 1125 Burtschell, Crescent City, CA 95531 | 2008-03-03 |
| Find all providers in zip 95531 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
| City | CRESCENT CITY |
| Zip Code | 95531 |
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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.