Basic Information
| Provider Information | |||||||||
| NPI: | 1235864109 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARECONNECTMD WASHINGTON PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3090 BRISTOL ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | COSTA MESA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926263061 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8887899585 | ||||||||
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| Practice Location | |||||||||
| Address1: | 450 ALASKAN WAY S STE 200 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981042785 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8887899585 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2022 | ||||||||
| LastUpdateDate: | 07/23/2022 | ||||||||
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| AuthorizedOfficialLastName: | COLLADO | ||||||||
| AuthorizedOfficialFirstName: | ORLANDO | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8887899585 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 07/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0300X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
No ID Information.