Raul Arturo Pardave MD a Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A45243 Issued in CA

Legal business name

RAUL ARTURO PARDAVE MD A MEDICAL CORPORATION

Practice address

1530 E Chevy Chase Dr
Suite 207
Glendale, CA 91206-4163

Phone

(818) 545-7418

Fax

(818) 844-0288

NPI assigned

Jan 18, 2008

Last updated

Oct 21, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Raul Arturo Pardave, M.D.NPI 1558460634

Title

President

Phone

(818) 421-1318

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Raul Arturo Pardave MD a Medical Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Raul Arturo Pardave, MD, a Medical Corporation

  • Non-Pharmacy Dispensing Site
  • Glendale, CA
  • NPI 1750641080
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Raul Arturo Pardave, MD, a Medical Corporation

  • Non-Pharmacy Dispensing Site
  • Glendale, CA
  • NPI 1750641080
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Raul A Pardave, MD

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1558460634
  Medicare reassignment NPD Authorized official
• Katharine Lee Pardave, N.P.

  • Acute Care Nurse Practitioner
  • Glendale, CA
  • NPI 1265780399
  NPD (past)

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287619200000",
    "number": "1427234558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 E CHEVY CHASE DR",
            "address_2": "SUITE 207",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064163",
            "telephone_number": "818-545-7418",
            "fax_number": "818-844-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 E CHEVY CHASE DR",
            "address_2": "SUITE 207",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064163",
            "telephone_number": "818-545-7418",
            "fax_number": "818-844-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAUL ARTURO PARDAVE MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2010-10-21",
        "status": "A",
        "authorized_official_last_name": "PARDAVE",
        "authorized_official_first_name": "RAUL",
        "authorized_official_middle_name": "ARTURO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-421-1318",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A45243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.