Organization
OLUWAGBENGA SERRANO
Active
Other names
O Serrano MD PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLUWAGBENGA SERRANO M.D. (OWNER)
(928) 367-3637
Entity
Organization
Contact information
Practice address
218 W WHITE MOUNTAIN BLVD, SUITE C, LAKESIDE, AZ 85929-7013
(928) 367-3637
(928) 367-3638
Mailing address
PO BOX 1149, LAKESIDE, AZ 85929-1149
(928) 367-3637
(928) 367-3638
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
29877
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025539
—
AZ
Enumeration date
01/17/2007
Last updated
01/13/2012
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