Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 036146672 | IL |
N | 208000000X | Pediatrician | 125066842 | IL |
NPI | 1386024164 |
---|---|
Provider Name | Cesar Ituriel Menchaca |
First Address | Pittsburgh, PA 15213 |
Second Address | Pittsburgh, PA 15224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2015 |
Last Update Date | 17/06/2019 |