Organization
HBP PEDIATRICS MEDICAL GROUP, INC,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERNIE MALDONADO MD (PRESIDENT)
(626) 397-3082
Entity
Organization
Contact information
Practice address
100 W CALIFORNIA BLVD, PEDIATRICS DEPARTMENT, PASADENA, CA 91105-3010
(626) 397-3082
Mailing address
223 N 1ST AVE, SUITE 201, ARCADIA, CA 91006-7089
(626) 821-1411
(626) 821-0406
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0090820
—
CA
01
—
ZZZ09025Z
BLUE SHIELD
CA
Enumeration date
08/08/2006
Last updated
08/22/2020
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