Individual
DR. JOHN MARDONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
47111 MONROE ST, PO DRAWER LLLL, INDIO, CA 92201-6739
(760) 347-6191
Mailing address
PO BOX 2993, INDIO, CA 92202-2993
(800) 819-2392
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A41581
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A415810
BLUE SHIELD
—
05
—
00A415810
—
CA
01
—
A41581
RIVERSIDE CO EMS
—
Enumeration date
06/23/2006
Last updated
08/26/2009
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