Provider Demographics
NPI:1942337092
Name:CALCARE MEDICAL INSTITUTE INC.
Entity Type:Organization
Organization Name:CALCARE MEDICAL INSTITUTE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:COUFAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-430-9180
Mailing Address - Street 1:655 S FLOWER ST
Mailing Address - Street 2:368
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-2805
Mailing Address - Country:US
Mailing Address - Phone:213-430-9180
Mailing Address - Fax:213-430-9193
Practice Address - Street 1:820 34TH ST
Practice Address - Street 2:102
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2283
Practice Address - Country:US
Practice Address - Phone:661-324-4434
Practice Address - Fax:661-324-4464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG 86420207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID #