Basic Information
Provider Information
NPI: 1861685786
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CESAR
FirstName: DENNIS
MiddleName: STEPHEN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 220 STANDIFORD AVE STE F
Address2:  
City: MODESTO
State: CA
PostalCode: 953501159
CountryCode: US
TelephoneNumber: 2095795628
FaxNumber: 2095795637
Practice Location
Address1: 220 E 13TH ST
Address2:  
City: MERCED
State: CA
PostalCode: 953416250
CountryCode: US
TelephoneNumber: 2093837534
FaxNumber: 2096778303
Other Information
ProviderEnumerationDate: 08/23/2007
LastUpdateDate: 07/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208800000XG33716CAY Allopathic & Osteopathic PhysiciansUrology 

No ID Information.


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