Basic Information
Provider Information
NPI: 1063526812
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CEPE
FirstName: EMMANUEL
MiddleName: DELA CRUZ
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2100 NAPA VALLEJO HWY
Address2:  
City: NAPA
State: CA
PostalCode: 945586293
CountryCode: US
TelephoneNumber: 7072535000
FaxNumber: 5106086055
Practice Location
Address1: 2100 NAPA VALLEJO HWY
Address2:  
City: NAPA
State: CA
PostalCode: 945586293
CountryCode: US
TelephoneNumber: 7072535000
FaxNumber: 5107970236
Other Information
ProviderEnumerationDate: 08/18/2006
LastUpdateDate: 07/31/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XC50296CAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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