Provider Demographics
NPI:1518995232
Name:SERNA, JORGE A (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MR
First Name:JORGE
Middle Name:A
Last Name:SERNA
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5873 E. FLORENCE AVE.
Mailing Address - Street 2:
Mailing Address - City:BELL GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90201
Mailing Address - Country:US
Mailing Address - Phone:323-562-6000
Mailing Address - Fax:323-562-6009
Practice Address - Street 1:5873 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:BELL GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90201-4610
Practice Address - Country:US
Practice Address - Phone:323-562-6000
Practice Address - Fax:323-562-6009
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 13561363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant