Healthcare Provider Details

I. General information

NPI: 1497813067
Provider Name (Legal Business Name): CESAR VILLARREAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 05/30/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3227 E BELL RD STE 170
PHOENIX AZ
85032-8710
US

IV. Provider business mailing address

2700 N CENTRAL AVE STE 1050
PHOENIX AZ
85004-1217
US

V. Phone/Fax

Practice location:
  • Phone: 602-652-3500
  • Fax: 602-652-3582
Mailing address:
  • Phone: 602-266-8402
  • Fax: 602-264-0887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number30915
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: