Provider Demographics
NPI:1043915440
Name:CALALO, RUBY ELAINE (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:RUBY ELAINE
Middle Name:
Last Name:CALALO
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 KATELLA AVE STE 315
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3377
Mailing Address - Country:US
Mailing Address - Phone:562-626-8016
Mailing Address - Fax:
Practice Address - Street 1:3851 KATELLA AVE STE 315
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3377
Practice Address - Country:US
Practice Address - Phone:562-626-8016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95024670363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care