Provider Demographics
NPI:1336302959
Name:CELADA, ROBERTO ARMANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:ARMANDO
Last Name:CELADA
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:501 S SHORE CTR W
Mailing Address - Street 2:SUITE 103F
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-5762
Mailing Address - Country:US
Mailing Address - Phone:510-814-4630
Mailing Address - Fax:510-814-4644
Practice Address - Street 1:501 S SHORE CTR W
Practice Address - Street 2:SUITE F
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-5762
Practice Address - Country:US
Practice Address - Phone:510-814-4630
Practice Address - Fax:510-814-4644
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA90276208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABG149Medicare PIN