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NPI Code Detail

MEDICARE: MR. ANTONIO CERDA

MEDICARE: MR. ANTONIO CERDA
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
1171M00000XCase Manager/Care Coordinator
2172V00000XCommunity Health Worker
3373H00000XDay Training/Habilitation Specialist

General Provider Information

NPI Number : 1952834566
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANTONIO CERDA
Provider Business Mailing Address
First Line : 1133 E RHEA ST
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-5125
Country : US
Telephone Number : 562-322-1677
Fax Number :
Provider Business Practice Location Address
First Line : 1133 E RHEA ST
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-5125
Country : US
Telephone Number : 562-278-6863
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2017
Last Update Date : 05/13/2025

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