Provider Demographics
NPI:1700998259
Name:VELUZ, CESAR P (MD)
Entity Type:Individual
Prefix:DR
First Name:CESAR
Middle Name:P
Last Name:VELUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:106 LYNCH CREEK WAY
Mailing Address - Street 2:SUITE 9B
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-2356
Mailing Address - Country:US
Mailing Address - Phone:707-763-1575
Mailing Address - Fax:707-763-9172
Practice Address - Street 1:106 LYNCH CREEK WAY
Practice Address - Street 2:SUITE 9B
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-2356
Practice Address - Country:US
Practice Address - Phone:707-763-1575
Practice Address - Fax:707-763-9172
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31051208600000X, 2086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A310510Medicaid
00A310510Medicare ID - Type Unspecified
CA00A310510Medicaid