Provider Demographics
NPI:1487337945
Name:MADRIGAL, EDUARDO
Entity type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:
Last Name:MADRIGAL
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 1:458 HEMLOCK AVE
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-8917
Mailing Address - Country:US
Mailing Address - Phone:559-560-6025
Mailing Address - Fax:
Practice Address - Street 1:458 HEMLOCK AVE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-8917
Practice Address - Country:US
Practice Address - Phone:559-560-6025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program