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General NPI Number Information
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NPI Number | 1134736705
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Entity Type | Organization
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Legal Business Name | SERAPHIM STEM CELL RESEARCH FOUNDATION
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Dates
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Enumeration Date | 09/28/2020
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Last Update Date | 12/10/2021
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Provider Practice Location Address
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Address Line | 960 E GREEN ST STE 101
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City | PASADENA
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State | CA
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Zip | 91106-2401
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Country | US
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Telephone | 256-348-5521
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Fax | 626-449-2759
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Provider Business Mailing Address
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Address Line | 960 E GREEN ST STE 101
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City | PASADENA
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State | CA
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Zip | 91106-2401
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Country | US
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Telephone | 626-449-1944
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Fax | 626-449-2759
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Authorized Official
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Title or Position | CEO
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Name | DR. GLADWIN GILL
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Credential | PH. D
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Telephone | 818-262-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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