Individual
OCTAVIO MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.A.
Contact information
Practice address
12730 HAWTHORNE BLVD STE D, HAWTHORNE, CA 90250-3919
(310) 644-4000
Mailing address
2525 E 129TH ST, COMPTON, CA 90222
(310) 447-1911
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
271
CA
Other
Enumeration date
07/27/2010
Last updated
07/27/2010
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