Healthcare Provider Details

I. General information

NPI: 1619217486
Provider Name (Legal Business Name): MATTHEW SERAFINE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2013
Last Update Date: 09/02/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MERCY CT
CAMP PENDLETON CA
92055
US

IV. Provider business mailing address

8839 W MANZANITA DR
PEORIA AZ
85345-2557
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-1288
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A13521
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number20A13521
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: