Healthcare Provider Details

I. General information

NPI: 1760435077
Provider Name (Legal Business Name): SERRANO ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 ROSECRANS AVE SPC 14
PARAMOUNT CA
90723-2532
US

IV. Provider business mailing address

7101 ROSECRANS AVE SPC 14
PARAMOUNT CA
90723-2532
US

V. Phone/Fax

Practice location:
  • Phone: 323-697-2229
  • Fax:
Mailing address:
  • Phone: 323-697-2229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ESPERANZA SERRANO
Title or Position: OFFICE MANAGER
Credential:
Phone: 323-697-2229