Provider Demographics
NPI:1801818273
Name:KALDOR, ERIC GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:GEORGE
Last Name:KALDOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 LAIDLEY ST
Mailing Address - Street 2:APT#1
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-2753
Mailing Address - Country:US
Mailing Address - Phone:650-315-5313
Mailing Address - Fax:
Practice Address - Street 1:1501 TROUSDALE DR
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4506
Practice Address - Country:US
Practice Address - Phone:650-315-5313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87622207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A876220Medicaid
CA00A876220Medicaid
CA94-6000524OtherCOUNTY OF MONTEREY EIN
00A876221Medicare PIN
CAH78120Medicare UPIN
CAP00444712Medicare PIN