John R Cercado, PA
Physician Assistant in Modesto, CA. Individual provider (NPI-1).
NPI number1497940407
StatusActive
Last updated in NPPESNov 8, 2019
Details
- NPI
- 1497940407
- Entity type
- Individual (NPI-1)
- Name
- John R Cercado
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 12, 2007
- Last updated
- Nov 8, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA16210 | CA | Yes |
| 363L00000X | Nurse Practitioner | 13918 | CA |
Practice location
1700 Coffee RdModesto, CA 95355-2803
Phone 209-526-4500
Mailing address
1700 Coffee RdModesto, CA 95355-2803
Phone 209-526-4500
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All 127 Physician Assistant providers in Modesto · All 10,803 providers in Modesto
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