Healthcare Provider Details

I. General information

NPI: 1679565006
Provider Name (Legal Business Name): ROBERTO J CALDERA PHARM D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL, CAMP PENDLETON BLDG H100, SANTA MARGARI ATTENTION: CODE CS-PA
CAMP PENDLETON CA
92055
US

IV. Provider business mailing address

5189 CERULEAN WAY
OCEANSIDE CA
92057-1842
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-3492
  • Fax:
Mailing address:
  • Phone: 760-805-8376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17584
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: