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General NPI Number Information
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NPI Number | 1417480336
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Entity Type | Individual
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Provider Name | DAVID SERRANO MD
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Gender | Male
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 500 W HOSPITAL RD
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City | FRENCH CAMP
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State | CA
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Zip | 95231-9693
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Country | US
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Telephone | 209-647-2184
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Fax |
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Provider Business Mailing Address
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Address Line | 250 CHERRY LN STE 116
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City | MANTECA
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State | CA
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Zip | 95337-4398
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A184704
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 125.071627
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License Number State | IL
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