Provider Demographics
NPI:1093471112
Name:SERACOLLECTION RESEARCH SERVICES
Entity Type:Organization
Organization Name:SERACOLLECTION RESEARCH SERVICES
Other - Org Name:SERACOLLECTION RESEARCH
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:B
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:323-621-6700
Mailing Address - Street 1:3317 W BEVERLY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-1572
Mailing Address - Country:US
Mailing Address - Phone:323-621-6700
Mailing Address - Fax:562-699-1502
Practice Address - Street 1:3317 W BEVERLY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-1572
Practice Address - Country:US
Practice Address - Phone:323-621-6700
Practice Address - Fax:562-699-1502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-12
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch