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General NPI Number Information
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NPI Number | 1043363872
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Entity Type | Individual
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Provider Name | CECELIA THERESA MADRID M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 02/20/2019
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Provider Practice Location Address
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Address Line | 2701 W ALAMEDA AVE STE 500
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City | BURBANK
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State | CA
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Zip | 91505-4410
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Country | US
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Telephone | 818-567-6550
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Fax | 818-558-4379
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Provider Business Mailing Address
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Address Line | 2701 W ALAMEDA AVE STE 500
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City | BURBANK
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State | CA
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Zip | 91505-4410
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Country | US
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Telephone | 818-567-6550
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Fax | 818-558-4379
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | G48480
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | G48480
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G48480
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G48480
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License Number State | CA
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