Individual provider Active NPI

Donald Edward Maldonado, MD

  • Pediatrics Physician
  • Anaheim, CA
National Provider Identifier
1447349014
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A46437 Issued in CA
Practice address
1820 W Lincoln Avenue
Anaheim, CA 92801-6730
Phone
(714) 635-0593
Fax
(714) 774-4784
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A46437 CA Primary

Addresses

Primary practice location

1820 W Lincoln Avenue
Anaheim, CA 92801-6730

Mailing address

1820 W Lincoln Ave
Anaheim, CA 92801-6730
Phone (714) 635-0593

Other identifiers 1

IdentifierTypeStateIssuer
00G464370MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120918000482 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7719135664

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1447349014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 W LINCOLN AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928016730",
            "telephone_number": "714-635-0593",
            "fax_number": "714-635-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 W LINCOLN AVENUE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928016730",
            "telephone_number": "714-635-0593",
            "fax_number": "714-774-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "DONALD",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A46437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G464370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.