MEDICARE: MR. JAMES GEORGE KALKANIS MD

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	207Y00000X	Otolaryngology Physician	A82979	CA

General Provider Information

NPI Number	:	1417039637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES GEORGE KALKANIS MD

Provider Business Mailing Address
First Line	:	341 MAGNOLIA AVENUE
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 AVENUE
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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	04/02/2012

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