MEDICARE: DR. MARY JOSELINE GASATAYA CENIZAL M.D.

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	207RI0200X	Infectious Disease Physician	A112709	CA
2	207RI0200X	Infectious Disease Physician	34887	AZ

General Provider Information

NPI Number	:	1750322178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY JOSELINE GASATAYA CENIZAL M.D.

Provider Business Mailing Address
First Line	:	137 E ELLIOT RD UNIT 3151
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85299-6850
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	137 E ELLIOT RD UNIT 3151
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85299-6850
Country	:	US
Telephone Number	:	763-330-8704
Fax Number	:

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	08/11/2025

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