Healthcare Provider Details

I. General information

NPI: 1316621527
Provider Name (Legal Business Name): CALEIGH HORAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2023
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9850 GENESEE AVE
LA JOLLA CA
92037-1224
US

IV. Provider business mailing address

1618 32ND ST
SAN DIEGO CA
92102-1608
US

V. Phone/Fax

Practice location:
  • Phone: 858-452-1279
  • Fax:
Mailing address:
  • Phone: 708-846-8639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20A25100
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: