MEDICARE: DR. JAMES JONATH CALATA CANONIZADO D.D.S.

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	1223G0001X	General Practice Dentistry	49482	CA

General Provider Information

NPI Number	:	1912029471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES JONATH CALATA CANONIZADO D.D.S.

Provider Business Mailing Address
First Line	:	3550 SAN PABLO DAM RD
Second Line	:	SUITE A6
City	:	EL SOBRANTE
State	:	CA
Zip	:	94803-2796
Country	:	US
Telephone Number	:	510-223-3337
Fax Number	:	510-223-5020

Provider Business Practice Location Address
First Line	:	3550 SAN PABLO DAM RD
Second Line	:	SUITE A6
City	:	EL SOBRANTE
State	:	CA
Zip	:	94803-2796
Country	:	US
Telephone Number	:	510-223-3337
Fax Number	:	510-223-5020

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

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	06/14/2010

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