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NPI Code Detail

MEDICARE: DR. JOHN ALBERT MALDONADO II MD

MEDICARE: DR. JOHN ALBERT MALDONADO II MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramTX
2207Q00000XFamily Medicine Physician20949NV

General Provider Information

NPI Number : 1124517412
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN ALBERT MALDONADO II MD
Provider Business Mailing Address
First Line : 1260 NEVADA PACIFIC BLVD
Second Line :
City : FERNLEY
State : NV
Zip : 89408-9871
Country : US
Telephone Number : 775-575-7171
Fax Number :
Provider Business Practice Location Address
First Line : 1260 NEVADA PACIFIC BLVD
Second Line :
City : FERNLEY
State : NV
Zip : 89408-9871
Country : US
Telephone Number : 775-575-7171
Fax Number : 775-575-7227
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2018
Last Update Date : 07/06/2021

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Directions to “ DR. JOHN ALBERT MALDONADO II MD” Practice Location

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