Healthcare Provider Details

I. General information

NPI: 1134396492
Provider Name (Legal Business Name): RAUL CALDERON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2008
Last Update Date: 06/14/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4955 VAN NUYS BLVD STE 505
SHERMAN OAKS CA
91403-1829
US

IV. Provider business mailing address

4955 VAN NUYS BLVD STE 505
SHERMAN OAKS CA
91403-1829
US

V. Phone/Fax

Practice location:
  • Phone: 818-444-4242
  • Fax: 800-448-2507
Mailing address:
  • Phone: 818-444-4242
  • Fax: 800-448-2507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA121016
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberA121016
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA121016
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: