Healthcare Provider Details

I. General information

NPI: 1851332241
Provider Name (Legal Business Name): SERRANO EYE CENTER MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4220 W 3RD ST SUITE 206
LOS ANGELES CA
90020-3450
US

IV. Provider business mailing address

4220 W 3RD ST SUITE 206
LOS ANGELES CA
90020-3450
US

V. Phone/Fax

Practice location:
  • Phone: 213-380-8800
  • Fax: 213-381-7474
Mailing address:
  • Phone: 213-380-8800
  • Fax: 213-381-7474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW S CHO
Title or Position: PARTNER
Credential: M.D.
Phone: 213-380-8800