Individual
MARY CAIZZA CERNI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1325 N ROSE DR, SUITE 203, PLACENTIA, CA 92870-3840
(714) 529-5674
(714) 529-6122
Mailing address
1325 N ROSE DR, SUITE 203, PLACENTIA, CA 92870-3840
(714) 529-5674
(714) 529-6122
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
20A5318
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F0732Z
MEDICARE PTAN
CA
01
—
P01003098
RAILROAD MEDICARE
CA
Enumeration date
10/05/2006
Last updated
03/17/2015
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