Provider Demographics
NPI:1790023877
Name:CARDENAS, CEZAR NOEL CALA
Entity Type:Individual
Prefix:
First Name:CEZAR NOEL
Middle Name:CALA
Last Name:CARDENAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 H ST
Mailing Address - Street 2:#100
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3446
Mailing Address - Country:US
Mailing Address - Phone:907-770-0862
Mailing Address - Fax:
Practice Address - Street 1:1600 W STRUCK AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-3427
Practice Address - Country:US
Practice Address - Phone:657-500-9419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95035963163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse