Provider Demographics
NPI:1750322178
Name:CENIZAL, MARY JOSELINE GASATAYA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY JOSELINE
Middle Name:GASATAYA
Last Name:CENIZAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 5223
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-0423
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6120 STONERIDGE MALL RD
Practice Address - Street 2:SUITE 110
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3296
Practice Address - Country:US
Practice Address - Phone:610-557-2452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ34887207RI0200X
CAA112709207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease