MEDICARE: JOSE CALDERON-ABBO, MD LLC

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
1	2084P0800X	Psychiatry Physician	14816R	LA

General Provider Information

NPI Number	:	1821303165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSE CALDERON-ABBO, MD LLC

Provider Business Mailing Address
First Line	:	3439 MAGAZINE ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-2446
Country	:	US
Telephone Number	:	504-891-8808
Fax Number	:	504-891-8883

Provider Business Practice Location Address
First Line	:	3439 MAGAZINE ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-2446
Country	:	US
Telephone Number	:	504-891-8808
Fax Number	:	504-891-8883

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. JOSE CALDERON-ABBO
Credential	:	M.D.
Telephone Number	:	504-891-8808

Provider Enumeration Date	:	08/11/2010
Last Update Date	:	08/11/2010

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