Samuel Maldonado Jr., BOCO

Primary specialty

OrthotistTaxonomy code 222Z00000X

License

C50102 Issued in CA

Practice address

2151 N. Harbor Blvd
Suite 1200
Fullerton, CA 92835-3821

Phone

(714) 871-9960

Fax

(714) 871-9965

NPI assigned

Feb 13, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hanger Prosthetics & Orthotics West Inc

  • Prosthetic/Orthotic Supplier
  • Fullerton, CA
  • NPI 1750707055

  Orthotist

  NPD (past)
• Hanger Prosthetics & Orthotics West Inc

  • Prosthetic/Orthotic Supplier
  • Lakewood, CA
  • NPI 1760968796
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1013456979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 N. HARBOR BLVD",
            "address_2": "SUITE 1200",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353821",
            "telephone_number": "714-871-9960",
            "fax_number": "714-871-9965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 N. HARBOR BLVD",
            "address_2": "SUITE 1200",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353821",
            "telephone_number": "714-871-9960",
            "fax_number": "714-871-9965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "SAMUEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "BOCO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "CA",
            "license": "C50102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anett Maldonado
• Gabrielle Maldonado
• Leonor Maldonado
• Maria Maldonado
• Mariah Maldonado
• Tina Maldonado
• Pouran Malekzadeh, MD
• Urvi Desai Malik, M.S., O.T.R./L.
• Saman Malkami, DMD
• Karen Malloy, MA

• Orthotist in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Orthotist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.