Provider Demographics
NPI:1124033600
Name:CUADROS, CESAR LUIS (MD)
Entity Type:Individual
Prefix:
First Name:CESAR
Middle Name:LUIS
Last Name:CUADROS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8232 LOUISIANA BLVD NE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-2429
Mailing Address - Country:US
Mailing Address - Phone:505-243-7670
Mailing Address - Fax:505-242-0510
Practice Address - Street 1:8232 LOUISIANA BLVD NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-2429
Practice Address - Country:US
Practice Address - Phone:505-243-7670
Practice Address - Fax:505-242-0510
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM88146208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM10975Medicaid
NME14596Medicare UPIN