Provider Demographics
NPI:1730289737
Name:CALOX INC
Entity Type:Organization
Organization Name:CALOX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:YAEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-255-5175
Mailing Address - Street 1:3034 FIERRO STREET
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065
Mailing Address - Country:US
Mailing Address - Phone:323-255-5175
Mailing Address - Fax:323-255-0656
Practice Address - Street 1:3034 FIERRO STREET
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90065
Practice Address - Country:US
Practice Address - Phone:323-255-5175
Practice Address - Fax:323-255-0656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ31406ZMedicaid
CAZZZ31406ZMedicaid