Provider Demographics
NPI:1982029583
Name:ANGELES, CESARIO A (DMD)
Entity Type:Individual
Prefix:DR
First Name:CESARIO
Middle Name:A
Last Name:ANGELES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13161 BLACK MOUNTAIN RD STE 3
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2685
Mailing Address - Country:US
Mailing Address - Phone:858-538-5387
Mailing Address - Fax:858-538-5463
Practice Address - Street 1:13161 BLACK MOUNTAIN RD STE 3
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-2685
Practice Address - Country:US
Practice Address - Phone:858-538-5387
Practice Address - Fax:858-538-5463
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39366122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist