Healthcare Provider Details

I. General information

NPI: 1932386174
Provider Name (Legal Business Name): CALVIN MCCARTY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 01/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21633 AVE 24
CHOWCHILLA CA
93610-0099
US

IV. Provider business mailing address

PO BOX 99 21633 AVE 24
CHOWCHILLA CA
93610-0099
US

V. Phone/Fax

Practice location:
  • Phone: 559-665-6100
  • Fax:
Mailing address:
  • Phone: 559-665-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number33808
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: