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SERRA COMMUNITY MEDICAL CLINIC INC. NPI 1477134302


NPI Information

NPI: 1477134302
Provider Name: SERRA COMMUNITY MEDICAL CLINIC, INC.

Doing Business As: SERRA COMMUNITY MEDICAL CLINIC- PACOIMA

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 05D2228243

Address:
10641 SAN FERNANDO RD FL 2
PACOIMA, CA
ZIP 91331
Phone: (818) 504-4700
Get Directions

SERRA COMMUNITY MEDICAL CLINIC, INC. is an internal medicine in Pacoima, CA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. SERRA COMMUNITY MEDICAL CLINIC, INC. NPI is 1477134302. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Serra Community Medical Clinic- Pacoima.

The provider's business location address is:

10641 SAN FERNANDO RD FL 2
PACOIMA, CA
ZIP 91331-626
Phone: (818) 504-4700
Fax: (818) 504-4690

The provider's authorized official is Lily Perez .
The authorized official title is Credentialing Coordinator and has the following contact phone number (818) 504-4701.

The CLIA number assigned to this NPI record is 05D2228243 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/21/2021 and was last updated on 1/11/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsNo
2207R00000XInternal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1239FQ0GBMEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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