Individual
JOSE L CERVANTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1601 N SEPULVEDA BLVD, #543, MANHATTAN BEACH, CA 90266-5111
(424) 217-3227
Mailing address
PO BOX 2705-605, HUNTINGTON BEACH, CA 92647
(562) 809-3571
(562) 468-0347
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A76360
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A763600
—
CA
05
—
00G812850
—
CA
Enumeration date
05/25/2006
Last updated
11/10/2014
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