Healthcare Provider Details

I. General information

NPI: 1598125130
Provider Name (Legal Business Name): CESAR A. VAZQUEZ M.D. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2016
Last Update Date: 02/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7125 N CHESTNUT AVE SUITE 101
FRESNO CA
93720-0358
US

IV. Provider business mailing address

7125 N CHESTNUT AVE SUITE 101
FRESNO CA
93720-0358
US

V. Phone/Fax

Practice location:
  • Phone: 559-549-6622
  • Fax: 559-549-5524
Mailing address:
  • Phone: 559-549-6622
  • Fax: 559-549-5524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA64057
License Number StateCA

VIII. Authorized Official

Name: CESAR ANIBAL VAZQUEZ
Title or Position: PEDIATRICIAN
Credential: M.D.
Phone: 559-594-6622