Provider Demographics
NPI:1831664689
Name:CEA SURGICAL SERVICES, INC
Entity Type:Organization
Organization Name:CEA SURGICAL SERVICES, INC
Other - Org Name:CEA SURGICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:E
Authorized Official - Last Name:AGUILUZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:310-600-6664
Mailing Address - Street 1:12499 VICTORIA GARDENS LN STE 103
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-7515
Mailing Address - Country:US
Mailing Address - Phone:909-463-0715
Mailing Address - Fax:
Practice Address - Street 1:12499 VICTORIA GARDENS LN STE 103
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739-7515
Practice Address - Country:US
Practice Address - Phone:909-463-0715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-09
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty