Provider Demographics
NPI:1922032986
Name:CALIMLIM, MARCELINO S JR (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCELINO
Middle Name:S
Last Name:CALIMLIM
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MARC
Other - Middle Name:S
Other - Last Name:CALIMLIM
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:15203 11TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-3737
Mailing Address - Country:US
Mailing Address - Phone:760-951-9985
Mailing Address - Fax:760-952-3387
Practice Address - Street 1:15203 11TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-3737
Practice Address - Country:US
Practice Address - Phone:760-951-9985
Practice Address - Fax:760-952-3387
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79537261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care