Provider Demographics
NPI:1013928837
Name:SERDEN, SCOTT P (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:P
Last Name:SERDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8631 W 3RD ST
Mailing Address - Street 2:SUITE 510E
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5901
Mailing Address - Country:US
Mailing Address - Phone:310-659-9104
Mailing Address - Fax:310-659-3049
Practice Address - Street 1:8631 W 3RD ST
Practice Address - Street 2:SUITE 510E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5901
Practice Address - Country:US
Practice Address - Phone:310-659-9104
Practice Address - Fax:310-659-3049
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG42693174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA92630Medicare UPIN
CAWG42693AMedicare PIN