Provider Demographics
NPI:1447280607
Name:CERJAN, JOSEPH GEORGE (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:GEORGE
Last Name:CERJAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1695 N SUNRISE WAY
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-3701
Mailing Address - Country:US
Mailing Address - Phone:603-237-2118
Mailing Address - Fax:
Practice Address - Street 1:4343 YAQUI PASS ROAD
Practice Address - Street 2:
Practice Address - City:BORREGO SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92004
Practice Address - Country:US
Practice Address - Phone:607-675-0517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45529207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ159766Medicaid
AZXPY191800Medicaid
AZE29450Medicare UPIN
AZ159766Medicaid