Organization
PRODE P. PASCUAL, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRODE PASCUAL (CEO)
(562) 865-0213
Entity
Organization
Contact information
Practice address
18331 GRIDLEY RD, SUITE C, CERRITOS, CA 90703-5438
(562) 865-0213
(562) 865-1050
Mailing address
18331 GRIDLEY RD, SUITE C, CERRITOS, CA 90703-5438
(562) 865-0213
(562) 865-1050
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A30986
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A309860
—
CA
01
—
A30986
MEDICARE ID-TYPE UNSPECIFIED
—
Enumeration date
08/18/2015
Last updated
08/18/2015
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