Provider Demographics
NPI:1407729692
Name:MALDONADO, RUBEN G
Entity type:Individual
Prefix:
First Name:RUBEN
Middle Name:G
Last Name:MALDONADO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8029 PATTON AVE
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-1547
Mailing Address - Country:US
Mailing Address - Phone:279-259-9403
Mailing Address - Fax:
Practice Address - Street 1:8029 PATTON AVE
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-1547
Practice Address - Country:US
Practice Address - Phone:279-259-9403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program