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NPI Code Detail

MEDICARE: MAURO HIDALGO

MEDICARE: MAURO HIDALGO
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1912686858
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAURO HIDALGO
Provider Business Mailing Address
First Line : 4500 PARK GRANADA STE 202
Second Line :
City : CALABASAS
State : CA
Zip : 91302-1666
Country : US
Telephone Number : 818-932-9644
Fax Number :
Provider Business Practice Location Address
First Line : 4500 PARK GRANADA STE 202
Second Line :
City : CALABASAS
State : CA
Zip : 91302-1666
Country : US
Telephone Number : 805-390-0973
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2023
Last Update Date : 07/17/2023

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Directions to “ MAURO HIDALGO ” 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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