Basic Information
| Provider Information | |||||||||
| NPI: | 1033147541 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CESARIO | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 441 N LAKEVIEW AVE | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928073028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | |||||||||
| FaxNumber: | 6264056768 | ||||||||
| Practice Location | |||||||||
| Address1: | 441 N LAKEVIEW AVE | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928073028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8889882800 | ||||||||
| FaxNumber: | 6264056768 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2006 | ||||||||
| LastUpdateDate: | 12/01/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | A69364 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 1356390009 | 01 | CA | GROUP NPI | OTHER | 00A693640 | 05 | CA | MEDICAID | W11675 | 01 | CA | GROUP MEDICARE PIN | OTHER | CE1617 | 01 | CA | GROUP RAILROAD MEDICARE | OTHER | GROO16910 | 01 | CA | GROUP MEDICAID PIN | OTHER |