Basic Information
| Provider Information | |||||||||
| NPI: | 1477884179 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CATALDO | ||||||||
| FirstName: | RAQUEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10442 MCCLEMONT AVE | ||||||||
| Address2: | |||||||||
| City: | TUJUNGA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 910421816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8183425897 | ||||||||
| FaxNumber: | 8189755008 | ||||||||
| Practice Location | |||||||||
| Address1: | 907 W LANCASTER BLVD | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935342305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189961051 | ||||||||
| FaxNumber: | 8189755013 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2010 | ||||||||
| LastUpdateDate: | 03/06/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.