Provider Demographics
NPI:1265413751
Name:TINT, CALVIN Z (MD)
Entity type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:Z
Last Name:TINT
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 1:11420 WARNER AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-2529
Mailing Address - Country:US
Mailing Address - Phone:714-549-1300
Mailing Address - Fax:
Practice Address - Street 1:11420 WARNER AVE
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-2529
Practice Address - Country:US
Practice Address - Phone:714-549-1300
Practice Address - Fax:714-433-3100
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41355207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A413550Medicaid
CAWA41355AMedicare PIN
CA00A413550Medicaid
CAES717ZMedicare PIN