Provider Demographics
NPI:1477884179
Name:CATALDO, RAQUEL
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:CATALDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10442 MCCLEMONT AVE
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-1816
Mailing Address - Country:US
Mailing Address - Phone:818-342-5897
Mailing Address - Fax:818-975-5008
Practice Address - Street 1:907 W LANCASTER BLVD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2305
Practice Address - Country:US
Practice Address - Phone:818-996-1051
Practice Address - Fax:818-975-5013
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-19
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care