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General NPI Number Information
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NPI Number | 1790172021
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Entity Type | Individual
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Provider Name | CESAR CORDERO SAM MD
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Gender | Male
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Dates
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Enumeration Date | 04/24/2015
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Last Update Date | 05/19/2023
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Provider Practice Location Address
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Address Line | 839 CALLE ANASCO APT 204
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City | SAN JUAN
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State | PR
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Zip | 00925-2451
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Country | US
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Telephone | 787-691-0766
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Fax |
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Provider Business Mailing Address
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Address Line | STATE ROAD 877 KM 1.6, CAMINO LAS LOMAS, RIO PIEDRAS
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 21642
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 21642
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License Number State | PR
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