Healthcare Provider Details

I. General information

NPI: 1770183717
Provider Name (Legal Business Name): SERENITY CANCER CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2020
Last Update Date: 10/29/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 E FIR AVE
FRESNO CA
93720-3859
US

IV. Provider business mailing address

7565 N CEDAR AVE STE 101
FRESNO CA
93720-2687
US

V. Phone/Fax

Practice location:
  • Phone: 650-561-3857
  • Fax:
Mailing address:
  • Phone: 650-561-3857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: OMID SAEED TEHRANI
Title or Position: PRESIDENT
Credential: MD, PHD
Phone: 650-561-3857