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General NPI Number Information
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NPI Number | 1588393755
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Entity Type | Individual
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Provider Name | JUAN RAPHAEL CALDERA PHD, D(ABMM)
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Gender | Male
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Dates
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Enumeration Date | 06/06/2022
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 33608 ORTEGA HWY
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-2042
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Country | US
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Telephone | 949-728-4880
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Fax |
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Provider Business Mailing Address
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Address Line | 7970 MISSION CENTER CT UNIT L
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City | SAN DIEGO
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State | CA
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Zip | 92108-1463
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Country | US
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Telephone | 626-864-3517
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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 | 246QM0900X
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Taxonomy Name | Microbiology Specialist/Technologist
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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 | 246QM0706X
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Taxonomy Name | Medical Technologist
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License Number | MTA00044966
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License Number State | CA
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