Provider Demographics
NPI:1760432041
Name:SERIO, M. K (MD)
Entity Type:Individual
Prefix:
First Name:M.
Middle Name:K
Last Name:SERIO
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 1:25990 ROTUNDA DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8967
Mailing Address - Country:US
Mailing Address - Phone:831-796-1630
Mailing Address - Fax:831-372-1666
Practice Address - Street 1:1441 CONSTITUTION BLVD
Practice Address - Street 2:CARDIOLOGY CLINIC
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3100
Practice Address - Country:US
Practice Address - Phone:831-796-1630
Practice Address - Fax:831-796-1616
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA47824207RC0000X, 207RI0011X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF82408Medicare UPIN
CA00A478240Medicare ID - Type Unspecified