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General NPI Number Information
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NPI Number | 1427234558
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Entity Type | Organization
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Legal Business Name | RAUL ARTURO PARDAVE MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/18/2008
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Last Update Date | 10/21/2010
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Provider Practice Location Address
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Address Line | 1530 E CHEVY CHASE DR SUITE 207
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City | GLENDALE
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State | CA
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Zip | 91206-4163
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Country | US
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Telephone | 818-545-7418
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Fax | 818-844-0288
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Provider Business Mailing Address
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Address Line | 1530 E CHEVY CHASE DR SUITE 207
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City | GLENDALE
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State | CA
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Zip | 91206-4163
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Country | US
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Telephone | 818-545-7418
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Fax | 818-844-0288
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAUL ARTURO PARDAVE
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Credential | M.D.
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Telephone | 818-421-1318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A45243
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License Number State | CA
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