Lakewood Functional Restoration ASC, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LAKEWOOD FUNCTIONAL RESTORATION ASC, LLC

Practice address

5750 Downey Ave Ste 302
Lakewood, CA 90712-1476

Phone

(661) 472-4177

NPI assigned

Feb 17, 2017

Organization subpart

No

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

Authorized official

Name

Elena Serda

Title

Director

Phone

(661) 472-4177

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487289600000",
    "number": "1194264556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 DOWNEY AVE STE 302",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121476",
            "telephone_number": "661-472-4177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 DOWNEY AVE STE 302",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121476",
            "telephone_number": "661-472-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD FUNCTIONAL RESTORATION ASC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-17",
        "last_updated": "2017-02-17",
        "status": "A",
        "authorized_official_last_name": "SERDA",
        "authorized_official_first_name": "ELENA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "661-472-4177"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Lakewood, CA
• Providers in Lakewood, 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 Feb 17, 2017; 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.