Healthcare Provider Details

I. General information

NPI: 1164240297
Provider Name (Legal Business Name): SERENA PARKER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2024
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8408 BEVERLY BLVD
LOS ANGELES CA
90048-3402
US

IV. Provider business mailing address

8408 BEVERLY BLVD
LOS ANGELES CA
90048-3402
US

V. Phone/Fax

Practice location:
  • Phone: 310-358-2400
  • Fax:
Mailing address:
  • Phone: 310-358-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number90147
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: