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General NPI Number Information
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NPI Number | 1578821575
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Entity Type | Individual
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Provider Name | DONALD VIDANA RCP, RRT, NPS
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Gender | Male
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Dates
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Enumeration Date | 04/26/2012
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Last Update Date | 04/26/2012
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Provider Practice Location Address
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Address Line | 6170 WINTERBERRY PL
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-9098
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Country | US
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Telephone | 951-897-7972
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Fax |
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Provider Business Mailing Address
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Address Line | 6170 WINTERBERRY PL
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-9098
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Country | US
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Telephone | 951-897-7972
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Fax |
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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 | 227800000X
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Taxonomy Name | Certified Respiratory Therapist
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License Number | 13993
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | 40763
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2279P3900X
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Taxonomy Name | Neonatal/Pediatric Registered Respiratory Therapist
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License Number |
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License Number State | CA
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