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General NPI Number Information
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NPI Number | 1154255610
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Entity Type | Organization
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Legal Business Name | SERENITY CARE HEALTH GROUP
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Dates
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Enumeration Date | 06/10/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 2412 E THOUSAND OAKS BLVD
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-3251
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Country | US
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Telephone | 562-478-4102
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Fax |
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Provider Business Mailing Address
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Address Line | 515 S FLOWER ST FL 18
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City | LOS ANGELES
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State | CA
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Zip | 90071-2201
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Country | US
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Telephone | 562-478-4102
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Fax |
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Authorized Official
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Title or Position | CLINIC OPERATIONS LEAD
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Name | DANIEL AVED SHAHGALDIANS
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Credential |
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Telephone | 818-642-2037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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