Provider Demographics
NPI:1629056130
Name:CALDER, DANIEL STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:STEVEN
Last Name:CALDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 BENNETT MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-8376
Mailing Address - Country:US
Mailing Address - Phone:707-525-0236
Mailing Address - Fax:
Practice Address - Street 1:1885 BENNETT MEADOWS LN
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-8376
Practice Address - Country:US
Practice Address - Phone:707-525-0236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG29647207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA44098Medicare UPIN