Mariam Amiri

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

240000308 Issued in CA

Legal business name

MARIAM AMIRI

Doing business as

Loma Linda Ambulatory Surgical Center

Practice address

11332 Mountain View Ave
Suite a
Loma Linda, CA 92354-3854

Phone

(909) 796-3707

Fax

(909) 796-3709

NPI assigned

Nov 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mariam S Amiri, DPM

Title

Owner

Phone

(909) 796-3707

Specialties & licenses 1

Addresses

Other names 1

• Loma Linda Ambulatory Surgical Center Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Barry Young, DPM

  • Podiatrist
  • Loma Linda, CA
  • NPI 1093968117
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1063692283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1069",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923541069",
            "telephone_number": "909-796-3707",
            "fax_number": "909-796-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11332 MOUNTAIN VIEW AVE",
            "address_2": "SUITE A",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543854",
            "telephone_number": "909-796-3707",
            "fax_number": "909-796-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIAM AMIRI",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "AMIRI",
        "authorized_official_first_name": "MARIAM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-796-3707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "240000308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Loma Linda Ambulatory Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Loma Linda Ambulatory Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Barbosa Manzanete
• Denise Mao
• Ryan Alistair John Marais, MD
• Mary Catherine Marciniak
• Rose Lily Marendes, NP STUDENT
• Mariam Amiri (Loma Linda Foot and Ankle Center)
• Mariam S Amiri D P M Professional Corporation (Loma Linda Ambulatory Surgical Ctr)
• Melinda San Gabriel Mariano, RN
• Mark Louis Mariglia
• Nicholas James Marinelli, DO

• Ambulatory Surgical Clinic/Center in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.