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General NPI Number Information
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NPI Number | 1891753315
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Entity Type | Individual
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Provider Name | MARIO L CEJA MD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 10/01/2021
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Provider Practice Location Address
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Address Line | 251 WEST COLE BOULEVARD
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City | CALEXICO
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State | CA
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Zip | 92231-9722
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Country | US
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Telephone | 760-357-3768
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Fax | 877-355-1742
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Provider Business Mailing Address
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Address Line | 2061 ROSS AVE STE B
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City | EL CENTRO
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State | CA
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Zip | 92243-3687
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Country | US
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Telephone | 760-357-3768
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Fax | 760-355-7731
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G79700
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License Number State | CA
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