Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 7904 | PR |
NPI | 1104018654 |
---|---|
Provider Name | Dr. Cesar H Trabanco |
First Address | Ponce, PR 00732-0578 |
Second Address | Ponce, PR 00717-1382 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2007 |
Last Update Date | 17/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
81371 | MEDICARE & SSS (01) | PR |
E20101 | (02) | PR |