Organization Active NPI

Laser Spine Center, LLC

  • Neurological Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1114758588
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
LASER SPINE CENTER, LLC
Practice address
2080 Century Park E Ste 500
Los Angeles, CA 90067-2008
Phone
(770) 997-0600
Fax
(678) 565-3625
NPI assigned
Aug 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Authorized official

Name
Shahram Rezaiamiri, MD
Title
Doctor
Phone
(770) 997-0600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

2080 Century Park E Ste 500
Los Angeles, CA 90067-2008

Mailing address

1944 Clairmont Rd
Decatur, GA 30033-3406
Phone (770) 997-0600

National Provider Directory

National Provider Directory

Locations

2080 Century Park E
Ste 500
Los Angeles, CA 90067
Phone (714) 508-1981

NPI Registry JSON

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723075200000",
    "number": "1114758588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1944 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333406",
            "telephone_number": "770-997-0600",
            "fax_number": "678-565-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK E STE 500",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900672008",
            "telephone_number": "770-997-0600",
            "fax_number": "678-565-3625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASER SPINE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A",
        "authorized_official_last_name": "REZAIAMIRI",
        "authorized_official_first_name": "SHAHRAM",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "770-997-0600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; 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.