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General NPI Number Information
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NPI Number | 1114208113
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Entity Type | Individual
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Provider Name | JOHN JOSEPH CERRONE M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/02/2011
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Last Update Date | 09/02/2011
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Provider Practice Location Address
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Address Line | 17891 SAN GABRIEL LANE 7816 SVL BOX
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City | VICTORVILLE
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State | CA
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Zip | 92395
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Country | US
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Telephone | 760-243-5801
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Fax | 760-243-5801
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Provider Business Mailing Address
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Address Line | 7816 SVL BOX
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City | VICTORVILLE
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State | CA
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Zip | 92395-5161
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Country | US
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Telephone | 760-243-5801
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Fax | 760-243-5801
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | G13103
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License Number State | CA
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