Provider Demographics
NPI:1235709387
Name:SERENITY HEALTHCARE PARTNERS INC
Entity Type:Organization
Organization Name:SERENITY HEALTHCARE PARTNERS INC
Other - Org Name:SERENITY HEALTHCARE PARTNERS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-715-2669
Mailing Address - Street 1:1111 W 6TH ST STE 111
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-1823
Mailing Address - Country:US
Mailing Address - Phone:818-535-9408
Mailing Address - Fax:
Practice Address - Street 1:1125 W 6TH ST STE 200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1895
Practice Address - Country:US
Practice Address - Phone:818-535-9408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-30
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty