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Individual
MR. EMANUEL HUERTA SERNA
Active
Individual
MR. EMANUEL HUERTA SERNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NA
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-2633765
MEDI-CAL
CA
Enumeration date
02/26/2020
Last updated
02/26/2020
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