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John Albert Maldonado

Family Medicine

Allopathic & Osteopathic Physicians

1260 Nevada Pacific Blvd, Fernley, NV 89408-9871

PECOS Enrollment

This provider is enrolled in PECOS as JOHN MALDONADO.

Based on the most recent information from CMS, provider John Albert Maldonado is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 9:30 AM.

Profile Details

Provider ID
1124517412
Provider Type
Individual
Full Name
Maldonado, John Albert
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
5/2/2018
Last Updated
7/6/2021

Contact Information

Practice Location

1260 Nevada Pacific Blvd, Fernley, NV 89408-9871

(775) 575-7171

(775) 575-7227

Mailing Location

1260 Nevada Pacific Blvd, Fernley, NV 89408-9871

(775) 575-7171

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 20949 Nevada
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer Texas

John Albert Maldonado

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

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Code

Description

License

Code

Description

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Code

Description

License

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