Provider Demographics
NPI:1336918507
Name:PAREDES MEDICAL CORPORATION
Entity Type:Organization
Organization Name:PAREDES MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GUSTAVO
Authorized Official - Middle Name:ADOLFO
Authorized Official - Last Name:PAREDES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-514-2269
Mailing Address - Street 1:49201 GRAPEFRUIT BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-1479
Mailing Address - Country:US
Mailing Address - Phone:760-514-2269
Mailing Address - Fax:
Practice Address - Street 1:49201 GRAPEFRUIT BLVD STE 3
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-1479
Practice Address - Country:US
Practice Address - Phone:760-514-2269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-28
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty