Basic Information
| Provider Information | |||||||||
| NPI: | 1992722854 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CESAR H TRABANCO DE LA CRUZ MD PSC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 10578 | ||||||||
| Address2: | |||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007320578 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878417168 | ||||||||
| FaxNumber: | 7878401552 | ||||||||
| Practice Location | |||||||||
| Address1: | 2225 PONCE BY PASS | ||||||||
| Address2: | 1006 PARRA MEDICAL INSTITUTE | ||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007171382 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878417168 | ||||||||
| FaxNumber: | 7878401552 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2006 | ||||||||
| LastUpdateDate: | 09/15/2008 | ||||||||
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| AuthorizedOfficialLastName: | TRABANCO | ||||||||
| AuthorizedOfficialFirstName: | CESAR | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7878417168 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | 7904 | PR | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.