Provider Demographics
NPI:1033154240
Name:CEPERO, OSCAR A (MD)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:A
Last Name:CEPERO
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 1:7904 VISTA CANELA
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-2911
Mailing Address - Country:US
Mailing Address - Phone:760-845-0012
Mailing Address - Fax:
Practice Address - Street 1:7904 VISTA CANELA
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-2911
Practice Address - Country:US
Practice Address - Phone:760-845-0012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2020-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67411207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A674110OtherBLUE SHIELD OF CA
CA00A674110Medicaid
CAWA67411BMedicare PIN
CA00A674110Medicaid