MEDICARE: CESAR VELEZ MEDICAL GROUP INC

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	208D00000X	General Practice Physician	A53490	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ50140Z	OTHER	CA	BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730231523
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CESAR VELEZ MEDICAL GROUP INC

Provider Business Mailing Address
First Line	:	1411 W SUNSET BLVD
Second Line	:	SUITE 203
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-3431
Country	:	US
Telephone Number	:	213-482-8313
Fax Number	:	213-481-8373

Provider Business Practice Location Address
First Line	:	1411 W SUNSET BLVD
Second Line	:	SUITE 203
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-3431
Country	:	US
Telephone Number	:	213-482-8313
Fax Number	:	213-481-8373

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CESAR A VELEZ
Credential	:	MD
Telephone Number	:	213-482-8313

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	07/08/2008

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