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General NPI Number Information
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NPI Number | 1164515136
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Entity Type | Organization
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Legal Business Name | CESAR A ESTELA M D A PROFESSIONAL CORP
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 03/05/2013
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Provider Practice Location Address
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Address Line | 1399 GALLERIA DR SUITE 100
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City | HENDERSON
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State | NV
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Zip | 89014-6663
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Country | US
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Telephone | 702-697-0020
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Fax | 702-697-0090
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Provider Business Mailing Address
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Address Line | 1399 GALLERIA DR SUITE 100
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City | HENDERSON
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State | NV
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Zip | 89014-6663
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Country | US
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Telephone | 702-697-0020
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Fax | 702-697-0090
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CESAR A ESTELA
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Credential | M D
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Telephone | 702-697-0020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 9610
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License Number State | NV
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