Provider Demographics
NPI:1639413230
Name:CALDAS, ANDRES FELIPE
Entity Type:Individual
Prefix:
First Name:ANDRES
Middle Name:FELIPE
Last Name:CALDAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 DENNERY RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-8495
Mailing Address - Country:US
Mailing Address - Phone:818-693-9042
Mailing Address - Fax:
Practice Address - Street 1:1052 DENNERY RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-8495
Practice Address - Country:US
Practice Address - Phone:818-693-9042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman