Healthcare Provider Details

I. General information

NPI: 1316062334
Provider Name (Legal Business Name): CESAR N NOCHE M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 E 200 S
SALT LAKE CITY UT
84111-2002
US

IV. Provider business mailing address

136 BELMONT CIR
UNIONTOWN PA
15401-4764
US

V. Phone/Fax

Practice location:
  • Phone: 800-366-1884
  • Fax:
Mailing address:
  • Phone: 724-437-5607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number11071
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: