Organization
NELSON R. MALDONADOM.D.,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NELSON R. MALDONADO M.D. (PRESIDENT)
(530) 477-0931
Entity
Organization
Contact information
Practice address
150 CATHERINE LN, SUITE G, GRASS VALLEY, CA 95945-5719
(530) 477-0931
(530) 477-0934
Mailing address
PO BOX 2618, GRASS VALLEY, CA 95945-2618
(530) 477-0931
(530) 477-0934
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
208600000X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G539150
—
CA
01
—
G53915
LICENCE
CA
Enumeration date
04/25/2007
Last updated
04/12/2012
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