| Doctor Name: | MR. RICHARD S BALDONADO |
| NPI Number: | 1295079259 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RVT |
| License Number: | 80940 |
| Business Practice Address: | 3534 Santa Carlotta St La Crescenta, CA - 912141115 |
| Business Phone Number: | 8189571652 |
| Business Fax Number: | 8189574672 |
| Mailing Address: | 3534 Santa Carlotta St, LA CRESCENTA |
| State: | CA |
| Postal Code: | 912141115 |
| Phone Number: | 8189571652 |
| Fax Number: | 8189574672 |
| NPI Enumeration Date: | 11/15/2012 |
| NPI Last Update Date: | 11/15/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246XC2903X |
| License Number: | 80940 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Spec/Tech, Cardiovascular |
| Taxonomy Specialization: | Vascular Specialist |
| Taxonomy Definition: | |