Provider Demographics
NPI:1225079049
Name:DELATORRE, CESAR A (MD)
Entity Type:Individual
Prefix:DR
First Name:CESAR
Middle Name:A
Last Name:DELATORRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1095 RYDAL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RYDAL
Mailing Address - State:PA
Mailing Address - Zip Code:19046-1711
Mailing Address - Country:US
Mailing Address - Phone:267-620-1100
Mailing Address - Fax:215-572-1279
Practice Address - Street 1:1095 RYDAL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RYDAL
Practice Address - State:PA
Practice Address - Zip Code:19046-1711
Practice Address - Country:US
Practice Address - Phone:267-620-1100
Practice Address - Fax:215-572-1279
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD066426L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001427748OtherHIGHMARK BLUE SHIELD
PA231937219OtherMULTIPLAN
PA100016837OtherPALMETTO GBA
PA231937219OtherTRICARE
PA14617OtherHEALTH PARTNERS
PA231937219OtherDEVON
PA001427748OtherAMERIHEALTH
PA001427748OtherPERSONAL CHOICE
PA2112918000OtherKEYSTONE HEALTH PLAN EAST
PA231937219OtherFIRST HEALTH
PA077793970001Medicaid
PA5545485OtherCIGNA
PA2930953OtherAETNA
PA231937219OtherDEVON