Healthcare Provider Details

I. General information

NPI: 1952644312
Provider Name (Legal Business Name): MARTIN ALEJANDRO CERDA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 N 92ND ST STE 101
SCOTTSDALE AZ
85258-4553
US

IV. Provider business mailing address

10101 N 92ND ST STE 101
SCOTTSDALE AZ
85258-4553
US

V. Phone/Fax

Practice location:
  • Phone: 480-747-6532
  • Fax: 480-889-6865
Mailing address:
  • Phone: 480-747-6532
  • Fax: 480-889-6865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC3500X
TaxonomyCardiac Rehabilitation Registered Nurse
License Number009603
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS13804
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberOP70025848
License Number StateWA
# 5
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number009603
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: