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NPI Code Detail

MEDICARE: MR. EFREN CALDERON JR. PTA

MEDICARE: MR. EFREN CALDERON JR. PTA
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
1225200000XPhysical Therapy Assistant014812AZ

General Provider Information

NPI Number : 1790631802
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EFREN CALDERON JR. PTA
Provider Business Mailing Address
First Line : 6223 S 6TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85041-5759
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1951 W CAMELBACK RD STE 450
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-3474
Country : US
Telephone Number : 602-601-2401
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2026
Last Update Date : 03/10/2026

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