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General NPI Number Information
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NPI Number | 1407171929
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Entity Type | Individual
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Provider Name | JOSEPH-PHILLIP T CALDERON II AEMT (TR-C)
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Gender | Male
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Dates
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Enumeration Date | 03/29/2010
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 36344 BASALT LN
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City | WINCHESTER
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State | CA
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Zip | 92596-4542
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Country | US
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Telephone | 858-922-4165
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Fax |
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Provider Business Mailing Address
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Address Line | 36344 BASALT LN
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City | WINCHESTER
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State | CA
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Zip | 92596-4542
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Country | US
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Telephone | 858-922-4165
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146M00000X
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Taxonomy Name | Intermediate Emergency Medical Technician
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License Number | A2042792
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 146D00000X
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Taxonomy Name | Personal Emergency Response Attendant
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License Number | TRC136
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number | 467907
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 2047-1340-4140
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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