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Organization

O.SERRANO, M.D. PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. OLUWAGBENGA SERRANO M.D. (PRESIDENT)
(480) 461-1135
Entity
Organization

Contact information

Practice address
37100 N GANTZEL RD, SAN TAN VALLEY, AZ 85140-7349
(480) 461-1135
(480) 461-1138
Mailing address
PO BOX 5027, MESA, AZ 85211-5027
(480) 461-1135
(480) 461-1138

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
29877
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
639396
AZ
Enumeration date
10/06/2011
Last updated
10/06/2011
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