Provider Demographics
NPI:1700992880
Name:ANACAYA, CALVIN TUNACAO (PT)
Entity Type:Individual
Prefix:MR
First Name:CALVIN
Middle Name:TUNACAO
Last Name:ANACAYA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 STEIN WAY
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-6063
Mailing Address - Country:US
Mailing Address - Phone:951-737-1328
Mailing Address - Fax:951-737-1328
Practice Address - Street 1:1365 STEIN WAY
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-6063
Practice Address - Country:US
Practice Address - Phone:951-737-1328
Practice Address - Fax:951-737-1328
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT258202251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ02967Medicare UPIN
CAWPT25820AMedicare PIN