MEDICARE: MAUDY KALANGIE DO

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	207L00000X	Anesthesiology Physician	20A11332	CA

General Provider Information

NPI Number	:	1447391347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUDY KALANGIE DO

Provider Business Mailing Address
First Line	:	1800 MEDICAL CENTER DR
Second Line	:	SUITE 105
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92411-1218
Country	:	US
Telephone Number	:	909-880-0536
Fax Number	:	909-880-0538

Provider Business Practice Location Address
First Line	:	1800 MEDICAL CENTER DR
Second Line	:	SUITE 105
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92411-1218
Country	:	US
Telephone Number	:	909-880-0536
Fax Number	:	909-880-0538

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

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	01/21/2011

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Directions to “ MAUDY KALANGIE DO” Practice Location

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