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General NPI Number Information
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NPI Number | 1508020322
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Entity Type | Organization
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Legal Business Name | MARIO A. PACADA, DPM, INC
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 3756 SANTA ROSALIA DR STE 302
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City | LOS ANGELES
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State | CA
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Zip | 90008-3615
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Country | US
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Telephone | 562-208-0713
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Fax | 562-684-0289
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Provider Business Mailing Address
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Address Line | 3756 SANTA ROSALIA DR STE 302
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City | LOS ANGELES
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State | CA
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Zip | 90008-3615
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Country | US
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Telephone | 562-208-0713
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Fax | 562-684-0289
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIO ANTONYO PACADA
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Credential | DPM
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Telephone | 562-209-0713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | E4163
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License Number State | CA
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