Blanca Estela Maldonado, OPTICIAN

Primary specialty

OpticianTaxonomy code 156FX1800X

License

SLD5882 Issued in CA

Practice address

671 E Cooley Dr Ste 102
Colton, CA 92324-4014

Phone

(909) 261-0483

NPI assigned

Aug 17, 2020

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1023620648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 DAVIDSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923541708",
            "telephone_number": "909-261-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 E COOLEY DR STE 102",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244014",
            "telephone_number": "909-261-0483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "BLANCA",
        "middle_name": "ESTELA",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "SLD5882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shabbir Makati, DDS
• Hasan Makda, MD, MS
• Making a Difference Association, Inc.
• Bahareh Maknouni
• Gayane Ani Malayan, DO
• Eric Alejandro Maldonado, LMFT
• Maxine Leah Malekmehr
• Norman Maletsky
• Sara Malik, MS
• Yousaf Iftikhar Malik, MD

• Optician in Colton, CA
• Providers in Colton, CA by specialty
• Optician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.