Organization
SERENITY OASIS MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD HUBBARD MD (OWNER/ MEDICAL DIRECTOR)
(818) 208-9344
Entity
Organization
Contact information
Practice address
14558 SYLVAN ST STE 104, VAN NUYS, CA 91411-2324
(818) 208-9344
Mailing address
14558 SYLVAN ST STE 104, VAN NUYS, CA 91411-2324
(818) 208-9344
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C22547
C22547
CA
Enumeration date
06/04/2022
Last updated
06/04/2022
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