Active NPI
Miracle Surgery Center,
- Plastic Surgery Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- 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, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Farzin Kerendian, D.O.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2051042 | Miracle Surgery Center | Certificate of waiver | Dec 10, 2026 |
National Provider Directory
National Provider DirectoryPractitioners & 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.
-
- Surgery Physician
- Los Angeles, CA
- NPI 1346388600
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.