Provider Demographics
NPI:1013065754
Name:SERRANO, HERALIO G (MD)
Entity Type:Individual
Prefix:DR
First Name:HERALIO
Middle Name:G
Last Name:SERRANO
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 1:3850 17TH ST
Mailing Address - Street 2:CASTRO-MISSION HEALTH CENTER
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-2031
Mailing Address - Country:US
Mailing Address - Phone:415-487-7500
Mailing Address - Fax:415-558-8221
Practice Address - Street 1:3850 17TH ST
Practice Address - Street 2:CASTRO-MISSION HEALTH CENTER
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-2031
Practice Address - Country:US
Practice Address - Phone:415-487-7500
Practice Address - Fax:415-558-8221
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG72733207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
028159OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER
028159OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER