Provider Demographics
NPI:1982874954
Name:CERNI, JOSEPH S (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:S
Last Name:CERNI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:JOSEPH
Other - Middle Name:S
Other - Last Name:CERNI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3620 BIRCH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2653
Mailing Address - Country:US
Mailing Address - Phone:949-553-0260
Mailing Address - Fax:949-735-6779
Practice Address - Street 1:3620 BIRCH ST STE 100
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2653
Practice Address - Country:US
Practice Address - Phone:949-553-0260
Practice Address - Fax:949-735-6779
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-06
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A4439207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine