Provider Demographics
NPI:1790858900
Name:SERON, GISELLE (MD)
Entity Type:Individual
Prefix:
First Name:GISELLE
Middle Name:
Last Name:SERON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:122 GOLDENWEST ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-3954
Mailing Address - Country:US
Mailing Address - Phone:424-409-7858
Mailing Address - Fax:972-218-0554
Practice Address - Street 1:8100 GARDEN GROVE BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-1016
Practice Address - Country:US
Practice Address - Phone:972-226-8900
Practice Address - Fax:972-218-0554
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY242370207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine