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NPI Code Detail

MEDICARE: CALVIN J RICK MD

MEDICARE: CALVIN J RICK MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianMD00028902WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568447738
Entity Type Code : Individual
Provider Name (Legal Business Name) : CALVIN J RICK MD
Provider Business Mailing Address
First Line : 55 W TIETAN ST
Second Line :
City : WALLA WALLA
State : WA
Zip : 99362-4445
Country : US
Telephone Number : 509-525-3720
Fax Number : 509-522-1593
Provider Business Practice Location Address
First Line : 55 W TIETAN ST
Second Line :
City : WALLA WALLA
State : WA
Zip : 99362-4445
Country : US
Telephone Number : 509-525-3720
Fax Number : 509-522-1593
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2005
Last Update Date : 07/21/2022

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