Mariam S Amiri D P M Professional Corporation

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MARIAM S AMIRI D P M PROFESSIONAL CORPORATION

Doing business as

Loma Linda Ambulatory Surgical Ctr

Practice address

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

Phone

(951) 314-3088

Fax

(951) 379-5310

NPI assigned

Jan 17, 2023

Last updated

Jun 15, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mariam Amiri, DPM

Title

Owner

Phone

(909) 522-7413

Specialties & licenses 1

Addresses

Other names 1

• LOMA LINDA AMBULATORY SURGICAL CTR Doing business as

Locations

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686787200000",
    "number": "1376258038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11332 MOUNTAIN VIEW AVE STE A",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543854",
            "telephone_number": "951-314-3088",
            "fax_number": "951-379-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11332 MOUNTAIN VIEW AVE STE A",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543854",
            "telephone_number": "951-314-3088",
            "fax_number": "951-379-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIAM S AMIRI D P M PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "AMIRI",
        "authorized_official_first_name": "MARIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-522-7413",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LOMA LINDA AMBULATORY SURGICAL CTR",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LOMA LINDA AMBULATORY SURGICAL CTR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ryan Alistair John Marais, MD
• Mary Catherine Marciniak
• Rose Lily Marendes, NP STUDENT
• Mariam Amiri (Loma Linda Ambulatory Surgical Center)
• Mariam Amiri (Loma Linda Foot and Ankle Center)
• Melinda San Gabriel Mariano, RN
• Mark Louis Mariglia
• Nicholas James Marinelli, DO
• Kristina Pulliam Markey, NP
• Rebecca Anne Markle, CRNA

• 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 Jun 15, 2023; 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.