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NPI Code Detail

MEDICARE: SERAPHIM STEM CELL RESEARCH FOUNDATION

MEDICARE: SERAPHIM STEM CELL RESEARCH FOUNDATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center
2261QH0100XHealth Service Clinic/Center
3261QM2500XMedical Specialty Clinic/Center
4207QA0505XAdult Medicine Physician

General Provider Information

NPI Number : 1134736705
Entity Type Code : Organization
Provider Name (Legal Business Name) : SERAPHIM STEM CELL RESEARCH FOUNDATION
Provider Business Mailing Address
First Line : 960 E GREEN ST STE 101
Second Line :
City : PASADENA
State : CA
Zip : 91106-2401
Country : US
Telephone Number : 626-449-1944
Fax Number : 626-449-2759
Provider Business Practice Location Address
First Line : 960 E GREEN ST STE 101
Second Line :
City : PASADENA
State : CA
Zip : 91106-2401
Country : US
Telephone Number : 256-348-5521
Fax Number : 626-449-2759
Authorized Official
Title or Position : CEO
Name : DR. GLADWIN GILL
Credential : PH. D
Telephone Number : 818-262-5900
Provider Enumeration Date : 09/28/2020
Last Update Date : 12/10/2021

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Directions to “SERAPHIM STEM CELL RESEARCH FOUNDATION ” Practice Location

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