Provider Demographics
NPI:1043287840
Name:CALMERE, JEFFERY ALLEN (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:ALLEN
Last Name:CALMERE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 SCOTT BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-6927
Mailing Address - Country:US
Mailing Address - Phone:408-296-0511
Mailing Address - Fax:408-296-1647
Practice Address - Street 1:770 SCOTT BLVD
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-6927
Practice Address - Country:US
Practice Address - Phone:408-296-0511
Practice Address - Fax:408-296-1647
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2007-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8937152W00000X, 152WC0802X, 152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT90986Medicare UPIN
CAYYY49956YMedicare PIN