Individual
REGINALD PIUS Q BALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14873 W BELL RD, SUITE 100, SURPRISE, AZ 85374-7609
(623) 815-7800
(623) 815-7900
Mailing address
9145 W THUNDERBIRD RD, SUITE 101, PEORIA, AZ 85381-4820
(623) 815-7800
(623) 815-7900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41409
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
457980
—
AZ
Enumeration date
08/06/2009
Last updated
03/06/2012
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