Healthcare Provider Details

I. General information

NPI: 1376300962
Provider Name (Legal Business Name): CESAR OCTAVIO FERNANDEZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/29/2024
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 W EAST AVE
CHICO CA
95926-2002
US

IV. Provider business mailing address

845 W EAST AVE
CHICO CA
95926-2002
US

V. Phone/Fax

Practice location:
  • Phone: 530-896-9400
  • Fax: 530-899-5162
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number109923
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: