Healthcare Provider Details

I. General information

NPI: 1194651257
Provider Name (Legal Business Name): MADELINE PADRON OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 W REDLANDS BLVD STE 101
REDLANDS CA
92373-3125
US

IV. Provider business mailing address

14726 RAMONA AVE STE 203
CHINO CA
91710-5730
US

V. Phone/Fax

Practice location:
  • Phone: 909-363-1450
  • Fax: 909-363-1480
Mailing address:
  • Phone: 626-305-9100
  • Fax: 626-305-0152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number36221
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: