MEDICARE: JAMES G. KALKANIS, MD A MEDICAL CORPORATION

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207YS0123X	Facial Plastic Surgery Physician
2	207YX0007X	Plastic Surgery within the Head & Neck (Otolaryngology) Physician
3	207Y00000X	Otolaryngology Physician

General Provider Information

NPI Number	:	1376709352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES G. KALKANIS, MD A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	341 MAGNOLIA AVE
Second Line	:	SUITE 206
City	:	CORONA
State	:	CA
Zip	:	92879-3332
Country	:	US
Telephone Number	:	951-735-0470
Fax Number	:	951-735-2842

Provider Business Practice Location Address
First Line	:	341 MAGNOLIA AVE
Second Line	:	SUITE 206
City	:	CORONA
State	:	CA
Zip	:	92879-3332
Country	:	US
Telephone Number	:	951-735-0470
Fax Number	:	951-735-2842

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JAMES GEORGE KALKANIS
Credential	:	M.D.
Telephone Number	:	951-735-0470

Provider Enumeration Date	:	07/30/2008
Last Update Date	:	03/21/2012

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