Provider Demographics
NPI:1326345398
Name:STEVEN R. CALLEROS, M.D., INC.
Entity Type:Organization
Organization Name:STEVEN R. CALLEROS, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:CALLEROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-838-5564
Mailing Address - Street 1:130 S IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-3943
Mailing Address - Country:US
Mailing Address - Phone:949-838-4465
Mailing Address - Fax:
Practice Address - Street 1:130 S IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-3943
Practice Address - Country:US
Practice Address - Phone:949-838-4465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-27
Last Update Date:2011-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA739242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty