Provider Demographics
NPI:1518099977
Name:MALDONADO, JANET (MD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CALIFORNIA ST
Mailing Address - Street 2:UNIT 14B
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-0001
Mailing Address - Country:US
Mailing Address - Phone:415-495-4978
Mailing Address - Fax:
Practice Address - Street 1:1750 EL CAMINO REAL
Practice Address - Street 2:SUITE NUMBER 206
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3228
Practice Address - Country:US
Practice Address - Phone:650-692-0182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA89537207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A895370Medicare PIN