Basic Information
| Provider Information | |||||||||
| NPI: | 1477215366 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PADDEN | ||||||||
| FirstName: | SEAN | ||||||||
| MiddleName: | KYLE | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | RCP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 215 E ELMWOOD AVE APT D | ||||||||
| Address2: | |||||||||
| City: | BURBANK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 915022639 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6616704127 | ||||||||
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| Practice Location | |||||||||
| Address1: | 501 S BUENA VISTA ST | ||||||||
| Address2: | |||||||||
| City: | BURBANK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 915054809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188435111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/08/2021 | ||||||||
| LastUpdateDate: | 10/08/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2279P3900X | 25773 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Neonatal/Pediatrics |
No ID Information.