Healthcare Provider Details

I. General information

NPI: 1467746362
Provider Name (Legal Business Name): JIM SORENA SERAJ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35876 WINCHESTER ROAD 300-335
WINCHESTER CA
92596
US

IV. Provider business mailing address

35876 WINCHESTER ROAD 300-335
WINCHESTER CA
92596
US

V. Phone/Fax

Practice location:
  • Phone: 949-549-1000
  • Fax: 762-200-7558
Mailing address:
  • Phone: 949-549-1000
  • Fax: 762-200-7337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA123641
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number51310
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036153092
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: