Provider Demographics
NPI:1669551644
Name:KALDAS, MAHER (RPH)
Entity type:Individual
Prefix:
First Name:MAHER
Middle Name:
Last Name:KALDAS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:PETER
Other - Middle Name:
Other - Last Name:KALDAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:13851 GARVEY AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-4913
Mailing Address - Country:US
Mailing Address - Phone:626-851-9199
Mailing Address - Fax:626-851-8053
Practice Address - Street 1:13851 GARVEY AVE
Practice Address - Street 2:
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-4913
Practice Address - Country:US
Practice Address - Phone:626-851-9199
Practice Address - Fax:626-851-8053
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39184183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA39184OtherRPH LICENSE #