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General NPI Number Information
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NPI Number | 1083347702
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Entity Type | Organization
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Legal Business Name | CAL-X FAMILY CLINIC PLC
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Dates
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Enumeration Date | 07/09/2022
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Last Update Date | 11/09/2022
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Provider Practice Location Address
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Address Line | 955 N MCQUEEN RD STE 2
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City | CHANDLER
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State | AZ
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Zip | 85225-8129
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Country | US
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Telephone | 602-617-9774
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Fax |
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Provider Business Mailing Address
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Address Line | 955 N MCQUEEN RD STE 2
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City | CHANDLER
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State | AZ
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Zip | 85225-8129
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Country | US
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Telephone | 602-617-9774
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MRS. TEKOYA MOSELINE CALIXTE
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Credential | FNP
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Telephone | 602-617-9774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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