Provider Demographics
NPI:1093226714
Name:CESAR ANTONIO FELIX
Entity Type:Organization
Organization Name:CESAR ANTONIO FELIX
Other - Org Name:CESAR ANTONIO FELIX D.D.S
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:FELIX
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:669-985-4824
Mailing Address - Street 1:4275 EXECUTIVE SQUARE
Mailing Address - Street 2:STE 200
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-9123
Mailing Address - Country:US
Mailing Address - Phone:619-488-3200
Mailing Address - Fax:866-272-6924
Practice Address - Street 1:AVE ZARAGOZA 945
Practice Address - Street 2:ZONA DORADA SUITE 1
Practice Address - City:MAZATLAN
Practice Address - State:SINALOA
Practice Address - Zip Code:82000
Practice Address - Country:MX
Practice Address - Phone:669-985-4824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-20
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ792226122300000X
ZZAE-115511223P0221X
ZZ38727051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty