Provider Demographics
NPI:1992722854
Name:CESAR H TRABANCO DE LA CRUZ MD PSC
Entity type:Organization
Organization Name:CESAR H TRABANCO DE LA CRUZ MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:H
Authorized Official - Last Name:TRABANCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-841-7168
Mailing Address - Street 1:PO BOX 10578
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-0578
Mailing Address - Country:US
Mailing Address - Phone:787-841-7168
Mailing Address - Fax:787-840-1552
Practice Address - Street 1:2225 PONCE BY PASS
Practice Address - Street 2:1006 PARRA MEDICAL INSTITUTE
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1382
Practice Address - Country:US
Practice Address - Phone:787-841-7168
Practice Address - Fax:787-840-1552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7904207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E20101Medicare UPIN
PR89872Medicare PIN