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NPI Code Detail

MEDICARE: GORAN CVIJANOVIC MD

MEDICARE: GORAN CVIJANOVIC MD
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
1207R00000XInternal Medicine PhysicianMD160261OR

General Provider Information

NPI Number : 1427393941
Entity Type Code : Individual
Provider Name (Legal Business Name) : GORAN CVIJANOVIC MD
Provider Business Mailing Address
First Line : P O BOX 748157
Second Line :
City : LOS ANGELES
State : CA
Zip : 90074-8157
Country : US
Telephone Number : 541-789-5250
Fax Number : 541-789-6553
Provider Business Practice Location Address
First Line : 1328 S MISSION RD
Second Line :
City : FALLBROOK
State : CA
Zip : 92028-4006
Country : US
Telephone Number : 760-451-4720
Fax Number : 760-451-4700
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2012
Last Update Date : 04/28/2020

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