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General NPI Number Information
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NPI Number | 1386442747
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Entity Type | Organization
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Legal Business Name | SRJ GROUP INC
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Dates
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Enumeration Date | 03/03/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 17515 CRENSHAW BLVD
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City | TORRANCE
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State | CA
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Zip | 90504-3403
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Country | US
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Telephone | 310-699-2107
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Fax |
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Provider Business Mailing Address
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Address Line | 17515 CRENSHAW BLVD
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City | TORRANCE
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State | CA
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Zip | 90504-3403
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Country | US
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Telephone | 310-699-2107
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | PADMA NAINA REDDY KASULA
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Credential | MD
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Telephone | 310-699-2105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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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 | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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