Joseph A. Cruz, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A49080 Issued in CA

Practice address

2 James Way
Suite 209
Pismo Beach, CA 93449-4973

Phone

(805) 773-7440

Fax

(805) 773-7448

NPI assigned

Jun 13, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Coastal Village Primary Care, a Medical Group

  • Family Medicine Physician
  • Pismo Beach, CA
  • NPI 1053742528
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1598769929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 JAMES WAY",
            "address_2": "SUITE 209",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934494973",
            "telephone_number": "805-773-7440",
            "fax_number": "805-773-7448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 JAMES WAY",
            "address_2": "SUITE 209",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934494973",
            "telephone_number": "805-773-7440",
            "fax_number": "805-773-7448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "JOSEPH",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A49080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "A49080",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA PIN",
            "identifier": "00A490800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimen M Colgan, PA
• Byron N Collier, DPM
• Teresa Maria Cordeiro, ANP
• County of San Luis Obispo (Judkins Middle School)
• Daniel Cramer I, M.D.
• Cambria Joy Dam-Mikkelsen, NTP
• Mark L Davis, DDS
• Camille Debruin
• Deneen C Dicarlo MD Inc a Prof Corp
• Dermatology Spa Med Inc

• Family Medicine Physician in Pismo Beach, CA
• Providers in Pismo Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.