Individual
PACIFICO DORADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
20404
KY
208600000X
Surgery Physician
Primary
35034105
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000589557
ANTHEM BCBS
KY
05
—
0216500
—
OH
05
—
64734940
—
KY
01
—
P00677401
RRMC
KY
01
—
P00776579
RR MEDICARE
OH
Enumeration date
08/02/2006
Last updated
01/28/2010
Update your record
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