Healthcare Provider Details
I. General information
NPI: 1003377409
Provider Name (Legal Business Name): ELINA SERRANO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/28/2019
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2335 STOCKTON BLVD FL 5
SACRAMENTO CA
95817-2201
US
IV. Provider business mailing address
2335 STOCKTON BLVD FL 5
SACRAMENTO CA
95817-2201
US
V. Phone/Fax
- Phone: 916-734-2111
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | A207198 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: