Healthcare Provider Details

I. General information

NPI: 1184879033
Provider Name (Legal Business Name): CESAR A CALDERA MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2008
Last Update Date: 04/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S CENTRAL AVE STE 125
GLENDALE CA
91204-2530
US

IV. Provider business mailing address

1500 S CENTRAL AVE STE 125
GLENDALE CA
91204-2530
US

V. Phone/Fax

Practice location:
  • Phone: 818-502-1160
  • Fax:
Mailing address:
  • Phone: 818-502-1160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CESAR A CALDERA
Title or Position: PRESIDENT
Credential: M.D
Phone: 818-502-1160