Provider Demographics
NPI:1528183209
Name:SERNA, EDWARD ARTURO (PA)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:ARTURO
Last Name:SERNA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16415 COLORADO AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-5051
Mailing Address - Country:US
Mailing Address - Phone:562-531-1946
Mailing Address - Fax:
Practice Address - Street 1:16415 COLORADO AVE STE 102
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-5051
Practice Address - Country:US
Practice Address - Phone:562-531-1946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17287363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical