MEDICARE: ANTHONY S PADULA M.D.

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
1	207R00000X	Internal Medicine Physician	A83508	CA
2	207RR0500X	Rheumatology Physician	A83508	CA
3	2080P0216X	Pediatric Rheumatology Physician	A83508	CA

General Provider Information

NPI Number	:	1235103813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY S PADULA M.D.

Provider Business Mailing Address
First Line	:	120 LA CASA VIA
Second Line	:	SUITE 204
City	:	WALNUT CREEK
State	:	CA
Zip	:	94598-3067
Country	:	US
Telephone Number	:	925-210-1050
Fax Number	:	925-210-1082

Provider Business Practice Location Address
First Line	:	120 LA CASA VIA
Second Line	:	SUITE 204
City	:	WALNUT CREEK
State	:	CA
Zip	:	94598-3067
Country	:	US
Telephone Number	:	925-210-1050
Fax Number	:	925-210-1082

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	07/28/2010

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