NOEL SERRANO MD PC
Complete NPI Record 1154010072
Internal Medicine in Oakland, CA
Active since May 05, 2023
Complete NPI Dataset
This page contains the complete raw NPPES record for Noel Serrano Md Pc (NPI 1154010072), an internal medicine organization in Oakland, CA. All 36 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
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Registry File Document Utilities
- NPI: 1154010072 Field 1/36
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/36
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/36
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: NOEL SERRANO MD PC Field 4/36
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider First Line Business Mailing Address: PO BOX 16309 Field 5/36
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: JACKSONVILLE Field 6/36
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: FL Field 7/36
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 322456309 Field 8/36
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 9/36
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider First Line Business Practice Location Address: 6117 FAIRLANE DR Field 10/36
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: OAKLAND Field 11/36
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: CA Field 12/36
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 946111807 Field 13/36
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 14/36
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 7075359279 Field 15/36
- The telephone number associated with the location address of the provider being identified.
- Authorized Official Last Name: SERRANO Field 18/36
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: NOEL Field 19/36
- The first name of the authorized official.
- Authorized Official Title or Position: OWNER Field 20/36
- The title or position of the authorized official.
- Authorized Official Telephone Number: 7075359279 Field 21/36
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 363LF0000X Field 22/36
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: N Field 23/36
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 363L00000X Field 24/36
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 2: N Field 25/36
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 3: 207Q00000X Field 26/36
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 3: N Field 27/36
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 4: 207R00000X Field 28/36
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 4: Y Field 29/36
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Organization Subpart: N Field 30/36
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Authorized Official Credential Text: MD Field 31/36
- The professional credential(s) of the authorized official listed on the provider's NPI record. Examples include MD (Doctor of Medicine), DO (Doctor of Osteopathy), RN (Registered Nurse), DDS (Doctor of Dental Surgery), PhD, or other recognized designations that reflect the official's qualifications.
- Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP Field 32/36
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
- Healthcare Provider Taxonomy Group 2: 193200000X MULTI-SPECIALTY GROUP Field 33/36
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
- Healthcare Provider Taxonomy Group 3: 193200000X MULTI-SPECIALTY GROUP Field 34/36
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
- Healthcare Provider Taxonomy Group 4: 193200000X MULTI-SPECIALTY GROUP Field 35/36
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Secondary Practice Locations 17
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
850 Sonoma Ave
Location 1/17Santa Rosa, CA 95404-4715 · Phone (707) 535-9279
446 Arrowood Dr
Location 2/17Santa Rosa, CA 95407-7503 · Phone (707) 535-9279
1035 Hwy 116 S
Location 3/17Sebastopol, CA 95472-4865 · Phone (707) 535-9279
45 Professional Center Pkwy
Location 4/17San Rafael, CA 94903-2702 · Phone (707) 535-9279
347 Andrieux St
Location 5/17Sonoma, CA 95476-6811 · Phone (707) 535-9279
1250 Broadway
Location 6/17Sonoma, CA 95476-7500 · Phone (707) 535-9279
300 Cherry Creek Rd
Location 7/17Cloverdale, CA 95425-3811 · Phone (707) 535-9279
705 Trancas St
Location 8/17Napa, CA 94558-3014 · Phone (707) 535-9279
3275 Villa Ln
Location 9/17Napa, CA 94558-3016 · Phone (707) 535-9279
450 Hayes Ln
Location 10/17Petaluma, CA 94952-4010 · Phone (707) 535-9279
1527 Springs Rd
Location 11/17Vallejo, CA 94591-5448 · Phone (707) 643-2267
1044 Heartwood Ave
Location 12/17Vallejo, CA 94591-5637 · Phone (707) 643-2267
523 Hayes Ln
Location 13/17Petaluma, CA 94952-4011 · Phone (707) 535-9279
260 Hospital Dr
Location 14/17Ukiah, CA 95482-4568 · Phone (707) 535-9279
300 Douglas St
Location 15/17Petaluma, CA 94952-2503 · Phone (707) 535-9279
40 Professional Center Pkwy
Location 16/17San Rafael, CA 94903-2703 · Phone (707) 535-9279
300 Fountaingrove Pkwy
Location 17/17Santa Rosa, CA 95403-5720 · Phone (707) 535-9279
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