MEDICARE: DR. CESAR ENRIQUE SIU O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	8860T	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699821967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CESAR ENRIQUE SIU O.D.

Provider Business Mailing Address
First Line	:	5923 REMER TER
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94555-3631
Country	:	US
Telephone Number	:	510-796-1990
Fax Number	:

Provider Business Practice Location Address
First Line	:	33800 ALVARADO NILES RD
Second Line	:	3
City	:	UNION CITY
State	:	CA
Zip	:	94587-4359
Country	:	US
Telephone Number	:	510-487-5856
Fax Number	:	510-487-3772

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	07/08/2007

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