Provider Demographics
NPI:1740372796
Name:CERNY, JOSEPH ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ANDREW
Last Name:CERNY
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 1:660 AUBURN FOLSOM RD
Mailing Address - Street 2:#205
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603
Mailing Address - Country:US
Mailing Address - Phone:530-888-9978
Mailing Address - Fax:530-888-9979
Practice Address - Street 1:660 AUBURN FOLSOM RD
Practice Address - Street 2:#205
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603
Practice Address - Country:US
Practice Address - Phone:530-888-9978
Practice Address - Fax:530-888-9979
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG077554207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G775541Medicaid
G13020Medicare UPIN
CA00G775541Medicaid