MEDICARE: DR. CHRISTIAN L. SERDAHL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	G064066	CA

General Provider Information

NPI Number	:	1740279710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTIAN L. SERDAHL M.D.

Provider Business Mailing Address
First Line	:	4925 J ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-3828
Country	:	US
Telephone Number	:	916-812-4524
Fax Number	:

Provider Business Practice Location Address
First Line	:	4925 J ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-3828
Country	:	US
Telephone Number	:	916-812-4524
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	03/05/2008

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