Provider Demographics
NPI:1801861661
Name:BRITO, CESAR GILBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:CESAR
Middle Name:GILBERTO
Last Name:BRITO
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 1:17300 N PERIMETER DR STE 220
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6703
Mailing Address - Country:US
Mailing Address - Phone:480-661-2662
Mailing Address - Fax:480-661-9716
Practice Address - Street 1:17300 N PERIMETER DR STE 220
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-6703
Practice Address - Country:US
Practice Address - Phone:480-661-2662
Practice Address - Fax:480-661-9716
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19879174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ15116Medicaid
AZ26-2944556OtherTAX ID
AZ15116Medicaid
AZ34WCHYSO5Medicare ID - Type Unspecified