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NPI Code Detail

MEDICARE: CESAREO G VASQUEZ M.D.

MEDICARE: CESAREO G VASQUEZ M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician8139AZ

General Provider Information

NPI Number : 1194806869
Entity Type Code : Individual
Provider Name (Legal Business Name) : CESAREO G VASQUEZ M.D.
Provider Business Mailing Address
First Line : 1441 N 12TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85006-2837
Country : US
Telephone Number : 602-747-4577
Fax Number :
Provider Business Practice Location Address
First Line : 301 S 7TH ST
Second Line :
City : WILLIAMS
State : AZ
Zip : 86046-2324
Country : US
Telephone Number : 928-635-4441
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2006
Last Update Date : 07/08/2007

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