MEDICARE: DR. EUGENE D. CATAQUIZ III D.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	1223G0001X	General Practice Dentistry	47051	CA

General Provider Information

NPI Number	:	1356453898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EUGENE D. CATAQUIZ III D.M.D.

Provider Business Mailing Address
First Line	:	11288 ARBORSIDE WAY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92131-1561
Country	:	US
Telephone Number	:	619-472-0400
Fax Number	:

Provider Business Practice Location Address
First Line	:	1035 HARBISON AVE
Second Line	:	STE. A
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-3919
Country	:	US
Telephone Number	:	619-472-0400
Fax Number	:

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	10/15/2015

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