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NPI Code Detail

MEDICARE: MARIO GALICIA MALDONADO

MEDICARE: MARIO GALICIA MALDONADO
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1265217350
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIO GALICIA MALDONADO
Provider Business Mailing Address
First Line : 4449 N 12TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-4520
Country : US
Telephone Number : 602-279-1427
Fax Number :
Provider Business Practice Location Address
First Line : 4930 W CRITTENDEN LN
Second Line :
City : PHOENIX
State : AZ
Zip : 85031-3168
Country : US
Telephone Number : 818-814-2692
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2023
Last Update Date : 08/28/2023

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Directions to “ MARIO GALICIA MALDONADO ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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