Individual
ERNIE MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 W CALIFORNIA BLVD, PEDIATRICS DEPARTMENT, PASADENA, CA 91105-3010
(626) 397-3082
Mailing address
223 N 1ST AVE, SUITE 201, ARCADIA, CA 91006-7089
(626) 821-1411
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A52512
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A525120
BLUE SHIELD
CA
Enumeration date
08/08/2006
Last updated
07/08/2007
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