1033214044 NPI number — DR. PATRICIA LOOT SALDANA M.D.

Table of content: DR. PATRICIA LOOT SALDANA M.D. (NPI 1033214044)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033214044 NPI number — DR. PATRICIA LOOT SALDANA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALDANA
Provider First Name:
PATRICIA
Provider Middle Name:
LOOT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033214044
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 899
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PASADENA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21123-0899
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-255-4500
Provider Business Mailing Address Fax Number:
410-255-8500

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8651 FORT SMALLWOOD RD
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
PASADENA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21122-2401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-255-4500
Provider Business Practice Location Address Fax Number:
410-255-8500
Provider Enumeration Date:
09/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  D0026872 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 27020000 . This is a "BS0 FED PROVIDER #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 139231000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7791 . This is a "BS0 PROVIDER #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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