Healthcare Provider Details

I. General information

NPI: 1447280607
Provider Name (Legal Business Name): JOSEPH GEORGE CERJAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 10/03/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4343 YAQUI PASS ROAD
BORREGO SPRINGS CA
92004
US

IV. Provider business mailing address

1695 N SUNRISE WAY
PALM SPRINGS CA
92262-3701
US

V. Phone/Fax

Practice location:
  • Phone: 607-675-0517
  • Fax:
Mailing address:
  • Phone: 603-237-2118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA45529
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: