Organization
RAYMUND O. PINEDA, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMUND O. PINEDA M.D. (OWNER)
(660) 829-3400
Entity
Organization
Contact information
Practice address
4400 S LIMIT AVE, STE B, SEDALIA, MO 65301-1179
(660) 829-3400
(660) 829-3433
Mailing address
4400 S LIMIT AVE, STE B, SEDALIA, MO 65301-1179
(660) 829-3400
(660) 829-3433
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
2005004444
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760624639
NPI INDIVIDUAL
—
01
—
1841262789
NPI GROUP
—
01
—
38568029
BC BS
MO
01
—
MA1749001
MEDICARE GROUP
—
Enumeration date
03/24/2009
Last updated
09/01/2010
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