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NPI Code Detail

MEDICARE: MR. JOSE RAMON ALDAZ

MEDICARE: MR. JOSE RAMON ALDAZ
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
13747A0650XAttendant Care Provider

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1F1151262OTHERCADRIVER LICENSE

General Provider Information

NPI Number : 1437709524
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSE RAMON ALDAZ
Provider Business Mailing Address
First Line : 14802 ROSEMARY DR
Second Line :
City : FONTANA
State : CA
Zip : 92335-6243
Country : US
Telephone Number : 562-786-0995
Fax Number :
Provider Business Practice Location Address
First Line : 1001 S HALE AVE SPC 54
Second Line :
City : ESCONDIDO
State : CA
Zip : 92029-2177
Country : US
Telephone Number : 760-739-9259
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2019
Last Update Date : 09/19/2019

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