Provider Demographics
NPI:1386024164
Name:MENCHACA, CESAR ITURIEL (MD)
Entity Type:Individual
Prefix:
First Name:CESAR
Middle Name:ITURIEL
Last Name:MENCHACA
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 1:3600 FORBES AVENUE
Mailing Address - Street 2:FORBES TOWER - PLAZA LEVEL SUITE 140
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4401 PENN AVENUE
Practice Address - Street 2:SUITE 02000, FACULTY PAVILION
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224
Practice Address - Country:US
Practice Address - Phone:412-647-3136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036146672207PP0204X
IL125066842208000000X
PAMT217869390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics