Provider Demographics
NPI:1801968292
Name:JOSEPH, CHERI SUE (LAC)
Entity type:Individual
Prefix:MS
First Name:CHERI
Middle Name:SUE
Last Name:JOSEPH
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Gender:F
Credentials:LAC
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Mailing Address - Street 1:1780 KETTNER BLVD
Mailing Address - Street 2:110
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-2552
Mailing Address - Country:US
Mailing Address - Phone:619-808-8314
Mailing Address - Fax:619-795-0846
Practice Address - Street 1:2180 GARNET AVE
Practice Address - Street 2:1-I
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-3610
Practice Address - Country:US
Practice Address - Phone:619-808-8314
Practice Address - Fax:619-795-0846
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAAC5486204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM