Provider Demographics
NPI:1760493886
Name:CALINISAN, JOAN HAZEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:HAZEL
Last Name:CALINISAN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:25485 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-6900
Mailing Address - Country:US
Mailing Address - Phone:951-894-4436
Mailing Address - Fax:951-301-6514
Practice Address - Street 1:25485 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-6900
Practice Address - Country:US
Practice Address - Phone:951-894-4436
Practice Address - Fax:951-301-6514
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2015-04-30
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Provider Licenses
StateLicense IDTaxonomies
CAA670410207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A670410Medicare PIN