MEDICARE: DR. CESAR A. CARDENAS 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
1	208600000X	Surgery Physician	168299	IA

General Provider Information

NPI Number	:	1255601811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CESAR A. CARDENAS M.D.

Provider Business Mailing Address
First Line	:	1400 W MAIN ST
Second Line	:
City	:	LAKE CITY
State	:	IA
Zip	:	51449-1577
Country	:	US
Telephone Number	:	712-464-3586
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 W MAIN ST
Second Line	:
City	:	LAKE CITY
State	:	IA
Zip	:	51449-1577
Country	:	US
Telephone Number	:	712-464-3586
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2012
Last Update Date	:	01/12/2012

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