Provider Demographics
NPI:1437734209
Name:PARKER-CALDERON, ELTON (RADT-1)
Entity Type:Individual
Prefix:
First Name:ELTON
Middle Name:
Last Name:PARKER-CALDERON
Suffix:
Gender:M
Credentials:RADT-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52355 AVENIDA RAMIREZ
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-3249
Mailing Address - Country:US
Mailing Address - Phone:760-883-1894
Mailing Address - Fax:
Practice Address - Street 1:47915 OASIS ST
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-6950
Practice Address - Country:US
Practice Address - Phone:760-563-8632
Practice Address - Fax:760-863-8631
Is Sole Proprietor?:No
Enumeration Date:2021-03-13
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA02084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry