Individual provider Active NPI

Manuel Angel Serrano

  • Student in an Organized Health Care Education/Training Program
  • Los Angeles, CA
National Provider Identifier
1902693369
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1670 E 120TH St
Los Angeles, CA 90059-3026
Phone
(323) 568-3314
NPI assigned
Apr 21, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1670 E 120TH St
Los Angeles, CA 90059-3026

Mailing address

9657 Linda Rio Dr
Sacramento, CA 95827-1055
Phone (562) 320-4009

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

NPI Registry JSON

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

{
    "created_epoch": "1745193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1902693369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9657 LINDA RIO DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958271055",
            "telephone_number": "562-320-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 E 120TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593026",
            "telephone_number": "323-568-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "MANUEL",
        "middle_name": "ANGEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-21",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; 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.