Healthcare Provider Details

I. General information

NPI: 1093636052
Provider Name (Legal Business Name): SERENITY CARE HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20061 SATICOY ST STE 101
WINNETKA CA
91306-2692
US

IV. Provider business mailing address

515 S FLOWER ST FL 18TH
LOS ANGELES CA
90071-2201
US

V. Phone/Fax

Practice location:
  • Phone: 747-206-5288
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: DANIEL AVED SHAHGALDIANS
Title or Position: CLINIC OPS LEAD
Credential:
Phone: 818-642-2037