Individual
MISS MARIA GUADALUPE MALDONADO
Active
Individual
MISS MARIA GUADALUPE MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA18520
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871689315
—
CA
01
—
95314536824
TIN
CA
05
—
EAP70768F
—
CA
05
—
FHC70768F
—
CA
05
—
HAP70768F
—
CA
01
—
PA18520
CA PA LICENSE
CA
01
—
W14338
MEDICARE CHAP PTAN
CA
Enumeration date
10/25/2006
Last updated
02/21/2011
Update your record
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