Richard S Baldonado, RVT

Individual provider Active NPI Vascular Specialist/Technologist Cardiovascular · La Crescenta, CA

NPI 1295079259 · NPPES record last updated Nov 15, 2012

Key facts

NPI
1295079259
Entity type
Individual (NPI type 1)
Primary specialty
Vascular Specialist/Technologist Cardiovascular 246XC2903X
License
80940 (CA)
Practice address
3534 Santa Carlotta St
La Crescenta, CA 91214-1115
Phone
(818) 957-1652
Fax
(818) 957-4672
NPI assigned
Nov 15, 2012
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
80940CAMDVascular Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
American Mobile Diagnostics Inc Vascular Specialist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Specialist/Technologist Cardiovascular 246XC2903X 80940 CA Yes

Addresses

Primary practice location

3534 Santa Carlotta St
La Crescenta, CA 91214-1115

Mailing address

3534 Santa Carlotta St
La Crescenta, CA 91214-1115
Phone (818) 957-1652

Other providers in La Crescenta, CA

All providers in La Crescenta, CA · Vascular Specialist/Technologist Cardiovascular in California

Sources for this page

Verify at the official NPI Registry.