MEDICARE: CALAGUAS LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1134363781
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALAGUAS LTD

Provider Business Mailing Address
First Line	:	3000 W CHARLESTON BLVD
Second Line	:	SUITE 5
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1906
Country	:	US
Telephone Number	:	702-877-9511
Fax Number	:	702-877-6711

Provider Business Practice Location Address
First Line	:	3000 W CHARLESTON BLVD
Second Line	:	SUITE 5
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1906
Country	:	US
Telephone Number	:	702-877-9511
Fax Number	:	702-877-6711

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	MR. BENITO CALDERON JR.
Credential	:	MD
Telephone Number	:	702-877-9511

Provider Enumeration Date	:	04/27/2009
Last Update Date	:	10/18/2023

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