Healthcare Provider Details

I. General information

NPI: 1306567540
Provider Name (Legal Business Name): RAYMOND CEZAR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2022
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15725 WHITTIER BLVD STE 500
WHITTIER CA
90603-2350
US

IV. Provider business mailing address

15725 WHITTIER BLVD STE 500
WHITTIER CA
90603-2350
US

V. Phone/Fax

Practice location:
  • Phone: 562-448-1350
  • Fax:
Mailing address:
  • Phone: 562-448-1350
  • Fax: 562-464-5122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number64275
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: