Organization
SERRA COMMUNITY MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LILY PEREZ (CREDENTIALING COORDINATOR)
(818) 768-3000
Entity
Organization
Contact information
Practice address
9375 SAN FERNANDO RD 6TH FLOOR, SUN VALLEY, CA 91352-1418
(818) 768-3000
(818) 504-4690
Mailing address
9375 SAN FERNANDO RD FL 6, SUN VALLEY, CA 91352-1418
(818) 768-3000
(818) 504-4690
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
—
CA
207L00000X
Anesthesiology Physician
—
CA
207QA0505X
Adult Medicine Physician
Primary
—
CA
207R00000X
Internal Medicine Physician
—
CA
207RH0003X
Hematology & Oncology Physician
—
CA
207V00000X
Obstetrics & Gynecology Physician
—
CA
207W00000X
Ophthalmology Physician
—
CA
207X00000X
Orthopaedic Surgery Physician
—
CA
2080A0000X
Pediatric Adolescent Medicine Physician
—
CA
2085R0202X
Diagnostic Radiology Physician
—
CA
208800000X
Urology Physician
—
CA
208VP0000X
Pain Medicine Physician
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0086550
—
CA
Enumeration date
08/13/2006
Last updated
07/21/2022
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