MEDICARE: DR. JOSEPH ANTHONY CARDENAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	21583	AZ

General Provider Information

NPI Number	:	1568432193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH ANTHONY CARDENAS MD

Provider Business Mailing Address
First Line	:	1975 W 24TH ST
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-6105
Country	:	US
Telephone Number	:	928-341-9522
Fax Number	:	928-341-8492

Provider Business Practice Location Address
First Line	:	1975 W 24TH ST
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-6105
Country	:	US
Telephone Number	:	928-341-9522
Fax Number	:	928-341-8492

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	02/26/2014

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