MEDICARE: DR. THOMAS WILLIAM CALLAN I M. D.

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	207RH0003X	Hematology & Oncology Physician	GFE26074	CA

General Provider Information

NPI Number	:	1699911487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS WILLIAM CALLAN I M. D.

Provider Business Mailing Address
First Line	:	PO BOX 904
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92022-0904
Country	:	US
Telephone Number	:	619-440-4421
Fax Number	:	619-593-2120

Provider Business Practice Location Address
First Line	:	230 CAJON VIEW DR
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-7502
Country	:	US
Telephone Number	:	619-440-4421
Fax Number	:	619-593-2120

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2008
Last Update Date	:	03/07/2023

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