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NPI Code Detail

MEDICARE: DR. RAYMUND O PINEDA M.D.

MEDICARE: DR. RAYMUND O PINEDA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RP1001XPulmonary Disease Physician036103774IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1036103774OTHERILMARION VA MEDICAL CENTER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
32005004444OTHERMOMEDICAL LICENSE

General Provider Information

NPI Number : 1841262789
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAYMUND O PINEDA M.D.
Provider Business Mailing Address
First Line : 2401 W MAIN ST
Second Line :
City : MARION
State : IL
Zip : 62959-1188
Country : US
Telephone Number : 618-997-5311
Fax Number :
Provider Business Practice Location Address
First Line : 2401 W MAIN ST
Second Line :
City : MARION
State : IL
Zip : 62959-1188
Country : US
Telephone Number : 618-997-5311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2006
Last Update Date : 09/23/2024

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