Provider Demographics
NPI:1144294455
Name:SERAFANO, DONALD N (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:N
Last Name:SERAFANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10861 CHERRY ST
Mailing Address - Street 2:STE 204
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-5402
Mailing Address - Country:US
Mailing Address - Phone:562-598-3160
Mailing Address - Fax:562-598-7383
Practice Address - Street 1:10861 CHERRY ST
Practice Address - Street 2:STE 204
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-5402
Practice Address - Country:US
Practice Address - Phone:562-598-3160
Practice Address - Fax:562-598-7383
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC37441207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC37441Medicare ID - Type Unspecified
A36628Medicare UPIN