Provider Demographics
NPI:1366640179
Name:ARNOLD BARRY CALICA, MD
Entity Type:Organization
Organization Name:ARNOLD BARRY CALICA, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAREN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-253-5453
Mailing Address - Street 1:PO BOX 40067
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85274-0067
Mailing Address - Country:US
Mailing Address - Phone:602-253-5453
Mailing Address - Fax:602-253-5997
Practice Address - Street 1:525 N 18TH ST STE 407
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-3746
Practice Address - Country:US
Practice Address - Phone:602-253-5453
Practice Address - Fax:602-253-5997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12548174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0258760OtherBLUE CROSS
AZ1215905401OtherNPI
AZ29064Medicare ID - Type UnspecifiedGROUP #
AZ1215905401OtherNPI
AZD36631Medicare UPIN