Healthcare Provider Details

I. General information

NPI: 1285063057
Provider Name (Legal Business Name): CALVIN EARL PEOPLES B.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2013
Last Update Date: 11/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5030 EL CAMINO AVE
CARMICHAEL CA
95608-4650
US

IV. Provider business mailing address

1525 BRIDGE ST APT 104
YUBA CITY CA
95993-8608
US

V. Phone/Fax

Practice location:
  • Phone: 916-609-4961
  • Fax: 916-609-5160
Mailing address:
  • Phone: 916-240-4487
  • Fax: 916-609-5160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: