Active NPI
Maria Guadalupe Maldonado, P.A.
- Medical Physician Assistant
- Los Angeles, CA
National Provider Identifier
1861577488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA18520
- Practice address
- 1200 N State St RM 1011
Los Angeles, CA 90033-1029 - Phone
- (323) 409-6715
- NPI assigned
- Oct 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA18520 | CA | Primary |
Addresses
Primary practice location
1200 N State St RM 1011
Los Angeles, CA 90033-1029
Mailing address
3228 Estado St
Pasadena, CA 91107-2916
Phone (323) 409-6715
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FHC70768F | Medicaid | CA | |
| W14338 | Other | CA | MEDICARE CHAP PTAN |
| HAP70768F | Medicaid | CA | |
| EAP70768F | Medicaid | CA | |
| 95314536824 | Other | CA | TIN |
| 1871689315 | Medicaid | CA | |
| PA18520 | Other | CA | CA PA LICENSE |
Other names 1
- Miss Maria G Maldonado
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA18520 | CA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298246400000",
"number": "1861577488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3228 ESTADO ST",
"city": "PASADENA",
"state": "CA",
"postal_code": "911072916",
"telephone_number": "323-409-6715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N STATE ST RM 1011",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331029",
"telephone_number": "323-409-6715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALDONADO",
"first_name": "MARIA",
"middle_name": "GUADALUPE",
"name_prefix": "Miss",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-25",
"last_updated": "2011-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA18520",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "FHC70768F",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE CHAP PTAN",
"identifier": "W14338",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "HAP70768F",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "EAP70768F",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TIN",
"identifier": "95314536824",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1871689315",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA PA LICENSE",
"identifier": "PA18520",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARIA",
"last_name": "MALDONADO",
"middle_name": "G",
"prefix": "MISS",
"credential": "P.A.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.