Individual provider Active NPI

Jose Serna, P.A.

  • Physician Assistant
  • Long Beach, CA
National Provider Identifier
1710168091
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 10134 Issued in CA
Practice address
1250 Pacific Ave
Long Beach, CA 90813-3026
Phone
(562) 437-0831
NPI assigned
Nov 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 10134 CA Primary

Addresses

Primary practice location

1250 Pacific Ave
Long Beach, CA 90813-3026

Mailing address

1250 Pacific Ave
Long Beach, CA 90813-3026
Phone (562) 437-0831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 10134CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Long Beach Neurological Medical Group, Inc. Past Accepting new patients
Care Onsite, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1710168091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133026",
            "telephone_number": "562-437-0831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133026",
            "telephone_number": "562-437-0831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERNA",
        "first_name": "JOSE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-15",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 10134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.