Healthcare Provider Details

I. General information

NPI: 1164365227
Provider Name (Legal Business Name): ZACHARY CALDERON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1127 WILSHIRE BLVD STE 300
LOS ANGELES CA
90017-3904
US

IV. Provider business mailing address

5555 GARDEN GROVE BLVD STE 200
WESTMINSTER CA
92683-8234
US

V. Phone/Fax

Practice location:
  • Phone: 213-481-1295
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA9134
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: