Healthcare Provider Details

I. General information

NPI: 1548599384
Provider Name (Legal Business Name): SERENO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2009
Last Update Date: 12/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 POST ST SUITE 6
SAN FRANCISCO CA
94104-4546
US

IV. Provider business mailing address

PO BOX 136
SAN FRANCISCO CA
94104-0136
US

V. Phone/Fax

Practice location:
  • Phone: 415-525-8400
  • Fax: 415-525-8733
Mailing address:
  • Phone: 415-525-8400
  • Fax: 415-525-8733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: MOLLY SHERRICK YOUNG
Title or Position: CHIEF NURSING OFFICER
Credential: NP
Phone: 415-525-8400