Organization Active NPI

Miracle Surgery Center,

  • Plastic Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1689324758
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
MIRACLE SURGERY CENTER,
Practice address
2080 Century Park East
Suite 606
Los Angeles, CA 90067
Phone
(310) 274-4900
NPI assigned
Mar 24, 2022
Last updated
Mar 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Authorized official

Name
Dr. Farzin Kerendian, D.O.NPI 1346388600
Title
Medical Director
Phone
(310) 274-4900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

2080 Century Park East
Suite 606
Los Angeles, CA 90067

Mailing address

2080 Century Park East
Suite 606
Los Angeles, CA 90067
Phone (310) 274-4900

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2051042Miracle Surgery Center2080 Century Park East, Ste. 606, Los Angeles, CA 90067Certificate of waiverDec 10, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648080000000",
    "number": "1689324758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK EAST",
            "address_2": "SUITE 606",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90067",
            "telephone_number": "310-274-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK EAST",
            "address_2": "SUITE 606",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90067",
            "telephone_number": "310-274-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE SURGERY CENTER,",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-24",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A",
        "authorized_official_last_name": "KERENDIAN",
        "authorized_official_first_name": "FARZIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-274-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic 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 Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.