Provider Demographics
NPI:1649392572
Name:SERRANO, JOSE L (DC, DACBR)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:L
Last Name:SERRANO
Suffix:
Gender:M
Credentials:DC, DACBR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7872 RONALD DR # A
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-7110
Mailing Address - Country:US
Mailing Address - Phone:714-791-2779
Mailing Address - Fax:714-843-4958
Practice Address - Street 1:7872 RONALD DR # A
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-7110
Practice Address - Country:US
Practice Address - Phone:714-791-2779
Practice Address - Fax:714-843-4958
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25506111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0200XChiropractic ProvidersChiropractorRadiology