KECK MEDICINE OF USC SURGERY CENTER, PASADENA - LLC
NPI 1922828284
Clinic/Center - Ambulatory Surgical in Pasadena, CA

Active since October 11, 2024CLIA 05D2330553 · Waiver
590 S FAIR OAKS AVE, PASADENA, CA 91105(323) 442-8747 Get Directions Write a Review

NPPES record last updated: May 16, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 16, 2025, Oct 11, 2024 (2 updates tracked since 2024).

About Keck Medicine Of Usc Surgery Center, Pasadena - Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KECK MEDICINE OF USC SURGERY CENTER, PASADENA - LLC (NPI 1922828284) is a healthcare organization registered as an ambulatory surgical in Pasadena, California and active in the NPI registry since October 2024. The organization holds a CLIA Waiver certificate valid through September 17, 2027 and lists Jeremy Church, Cfo/usc Care Medical Group, Inc., as its authorized official.

NPPES Registry Identity

NPI1922828284
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameKECK MEDICINE OF USC SURGERY CENTER, PASADENA - LLC
Location Address590 S FAIR OAKS AVEPasadena, CA 91105-2614
Mailing Address590 S Fair Oaks AvePasadena, CA 91105-2614 · (323) 442-8747
Organization SubpartYesParent: Keck Medicine Of Usc Surgery Centers, Llc
Authorized OfficialJeremy ChurchCfo/usc Care Medical Group, Inc. · (323) 442-8747
Enumeration DateOctober 11, 2024
Last NPPES UpdateMay 16, 20252 updates tracked since enumeration
NPPES CertifiedMay 16, 2025
NPI 1922828284 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
590 S FAIR OAKS AVE, Pasadena, CA 91105

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2330553

Keck Medicine Of Usc Surgery Center-Pasadena LLC · Pasadena, CA
Active · expires Sep 17, 2027
CLIA Number05D2330553
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateSeptember 18, 2025
Certificate Expiration DateSeptember 17, 2027
Laboratory DirectorJay R. Leiberman
Laboratory Phone(805) 679-6698
Laboratory LocationKeck Medicine Of Usc Surgery Center-Pasadena LLC590 S Fair Oaks Ave, Pasadena, CA 91105
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keck Medicine Of Usc Surgery Center, Pasadena - LLC's NPI number?

The NPI number for Keck Medicine Of Usc Surgery Center, Pasadena - LLC is 1922828284. It was assigned to this organization in the NPPES registry on October 11, 2024.

Where is Keck Medicine Of Usc Surgery Center, Pasadena - LLC located?

Keck Medicine Of Usc Surgery Center, Pasadena - LLC is located at 590 S Fair Oaks Ave, Pasadena, CA 91105. The listed phone number is (323) 442-8747.

What is Keck Medicine Of Usc Surgery Center, Pasadena - LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Keck Medicine Of Usc Surgery Center, Pasadena - LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2330553) is associated with this NPI, valid through September 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Keck Medicine Of Usc Surgery Center, Pasadena - LLC was last updated on May 16, 2025, 14 months ago. NPI Profile syncs with the weekly NPPES data releases published by CMS; the most recent full sync was completed on July 26, 2026. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.