Provider Demographics
NPI:1699416099
Name:CHRISTIAN CALZADA
Entity Type:Organization
Organization Name:CHRISTIAN CALZADA
Other - Org Name:CHRISTIAN REYES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALZADA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-272-9021
Mailing Address - Street 1:PO BOX 803
Mailing Address - Street 2:
Mailing Address - City:TECATE
Mailing Address - State:CA
Mailing Address - Zip Code:91980-0803
Mailing Address - Country:US
Mailing Address - Phone:619-272-9021
Mailing Address - Fax:
Practice Address - Street 1:PASEO MORELOS #887 COL INDUSTRIAL
Practice Address - Street 2:
Practice Address - City:TECATE
Practice Address - State:BAJA CALIFORNIA
Practice Address - Zip Code:21430
Practice Address - Country:MX
Practice Address - Phone:619-272-9021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty