Provider Demographics
NPI:1790979698
Name:KALDAS, MARIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIAN
Middle Name:
Last Name:KALDAS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:757 WESTWOOD PLZ
Mailing Address - Street 2:7501
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-8358
Mailing Address - Country:US
Mailing Address - Phone:310-267-9643
Mailing Address - Fax:310-267-3840
Practice Address - Street 1:757 WESTWOOD PLZ
Practice Address - Street 2:7501
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-8358
Practice Address - Country:US
Practice Address - Phone:310-267-9643
Practice Address - Fax:310-267-3840
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2018-10-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA107630207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1790979698OtherCCS PANELED PROVIDER
CA1790979698Medicaid
CAGF312ZMedicare PIN