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NPI Code Detail

MEDICARE: DARYL PINEDO MD

MEDICARE: DARYL PINEDO 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
12085R0202XDiagnostic Radiology PhysicianD73346MD

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01266895OTHERMORR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609098110
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARYL PINEDO MD
Provider Business Mailing Address
First Line : 1600 N 2ND ST
Second Line :
City : CLINTON
State : MO
Zip : 64735-1297
Country : US
Telephone Number : 660-885-5511
Fax Number :
Provider Business Practice Location Address
First Line : 1600 N 2ND ST
Second Line :
City : CLINTON
State : MO
Zip : 64735-1297
Country : US
Telephone Number : 660-885-5511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2007
Last Update Date : 07/07/2022

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Directions to “ DARYL PINEDO MD” Practice Location

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