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Organization

SERENE HEALTH IPA MEDICAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
OSCAR MEDINA (CEO)
(619) 259-6999
Entity
Organization

Contact information

Practice address
523 BLACKBURN DR STE 523, AUGUSTA, GA 30907-8202
(844) 737-3638
(619) 403-9496
Mailing address
9265 SKY PARK CT STE 100, SAN DIEGO, CA 92123-4375
(844) 737-3638
(619) 403-9496

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
1041C0700X
Clinical Social Worker
171M00000X
Case Manager/Care Coordinator
2084P0800X
Psychiatry Physician
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
04/03/2023
Last updated
11/22/2024
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