Provider Demographics
NPI:1740278092
Name:BALTODANO, FRANCISCO F (OTRL)
Entity type:Individual
Prefix:MR
First Name:FRANCISCO
Middle Name:F
Last Name:BALTODANO
Suffix:
Gender:M
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 E INDIAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1839
Mailing Address - Country:US
Mailing Address - Phone:026-277-5551
Mailing Address - Fax:
Practice Address - Street 1:650 E INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1839
Practice Address - Country:US
Practice Address - Phone:602-277-5551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3277225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ893166Medicaid
AZDF7521OtherRAILROAD MEDICARE DHT GROUP NUMBER
AZZ113264Medicare PIN
AZ5824180009Medicare NSC
AZ1396819546Medicare NSC
Q31489Medicare UPIN
AZ5824180003Medicare NSC
AZ100363Medicare PIN
AZ1740278092Medicare NSC
AZDF7521OtherRAILROAD MEDICARE DHT GROUP NUMBER
AZ893166Medicaid
AZ5824180005Medicare NSC
AZ1831211143Medicare NSC
AZ113184Medicare PIN
AZ1568521821Medicare NSC
AZ1164581427Medicare NSC