Healthcare Provider Details

I. General information

NPI: 1043403215
Provider Name (Legal Business Name): RANDA SERAG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27051 TOWNE CENTRE DR STE 280
LAKE FOREST CA
92610-2819
US

IV. Provider business mailing address

27051 TOWNE CENTRE DR STE 280
LAKE FOREST CA
92610-2819
US

V. Phone/Fax

Practice location:
  • Phone: 949-652-7580
  • Fax: 833-455-6567
Mailing address:
  • Phone: 949-652-7580
  • Fax: 833-455-6567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA106929
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: