Healthcare Provider Details

I. General information

NPI: 1851634257
Provider Name (Legal Business Name): ROBERT CELARDO RCP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4105 LITTLE HOLLOW PL
MOORPARK CA
93021-3118
US

IV. Provider business mailing address

13652 CANTARA ST # 109
PANORAMA CITY CA
91402-5423
US

V. Phone/Fax

Practice location:
  • Phone: 805-259-4112
  • Fax:
Mailing address:
  • Phone: 818-375-2901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number8605
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number8605
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: