Serrand Medical Center Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHY21856 Issued in CA

Legal business name

SERRAND MEDICAL CENTER PHARMACY

Practice address

4220 West 3Rd St
Suite #100
Los Angeles, CA 90020

Phone

(213) 381-3855

Fax

(213) 381-3856

NPI assigned

Nov 21, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chang Kyu Park, PHARM D

Title

Owner

Phone

(310) 472-6308

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1013082783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 WEST 3RD ST",
            "address_2": "SUITE #100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90020",
            "telephone_number": "213-381-3855",
            "fax_number": "213-381-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 WEST 3RD ST",
            "address_2": "SUITE #100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90020",
            "telephone_number": "213-381-3855",
            "fax_number": "213-381-3856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERRAND MEDICAL CENTER PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "CHANG",
        "authorized_official_middle_name": "KYU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-472-6308",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY21856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA218560",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "PHY21856",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacy Serpas-Hernandez, LMFT
• Lilian Jannet Serpas, MPH, PA-C
• Dee Jay Serpaz, RN
• Jasmine Serpen
• Maurizio Massimo Serra
• Sandra Serrano Canete
• Serrano Eye Center Medical Group
• Serrano Healthcare, LLC
• Serrano Medical Pharmacy, Inc.
• Serrano Post Acute, LLC

• Pharmacy in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.