Provider Demographics
NPI:1821069436
Name:VAZQUEZ, CESAR (MD)
Entity Type:Individual
Prefix:
First Name:CESAR
Middle Name:
Last Name:VAZQUEZ
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 1:7125 N CHESTNUT AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0358
Mailing Address - Country:US
Mailing Address - Phone:559-549-6622
Mailing Address - Fax:559-549-5524
Practice Address - Street 1:7125 N CHESTNUT AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0358
Practice Address - Country:US
Practice Address - Phone:559-549-6622
Practice Address - Fax:559-549-5524
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA64057208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH02334Medicare UPIN