Individual
DR. DANIEL CARRILLO MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1701 E CESAR CHAVEZ AVE, SUITE 402, LOS ANGELES, CA 90033-2464
(323) 317-9200
(323) 317-9206
Mailing address
5823 YORK BLVD STE 3, LOS ANGELES, CA 90042-2634
(323) 255-5643
(323) 254-2158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A74326
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A743260
BLUE SHIELD
CA
05
—
00A743260
—
CA
01
—
P00017937
MEDICARE RAILROAD
GA
Enumeration date
05/18/2006
Last updated
01/11/2018
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