Organization Name: | SERRA COMMUNITY MEDICAL CLINIC INC |
NPI Number: | 1275545725 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KARLA PIETERS (ADMINISTRATOR/CFO) |
Mailing Address: | 9375 San Fernando Rd 6th Floor Sun Valley |
State: | CA US |
Postal Code: | 913521418 |
Phone Number: | 8187683000 |
Fax Number: | 8185044690 |
NPI Enumeration Date: | 08/13/2006 |
NPI Last Update Date: | 10/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207KA0200X |
License Number: | ========= |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Allergy & Immunology |
Taxonomy Specialization: | Allergy |
Taxonomy Definition: |