=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336001528
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SERENITY SENIOR CARE, APC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/26/2025
-----------------------------------------------------
Last Update Date | 11/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2061 ROSS AVE SUITE B
-----------------------------------------------------
City | EL CENTRO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92243
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 442-231-8521
-----------------------------------------------------
Fax | 442-231-8561
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2061 ROSS AVE SUITE B
-----------------------------------------------------
City | EL CENTRO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92243
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 442-231-8521
-----------------------------------------------------
Fax | 442-231-8561
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JULIO MARTINEZ
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 442-231-8521
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------