NPI 1013456979

Samuel Maldonado, BOCO

Practitioner Orthotist Fullerton, CA

Practice location

Address: 2151 N. Harbor Blvd Suite 1200, Fullerton, CA 92835-3821
Phone: (714) 871-9960
Fax: (714) 871-9965

Registered specialties

Orthotist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X Licence C50102 (CA)

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Registry record

NPI: 1013456979
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Feb 2017
Record last updated: 13 Feb 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.