Provider Demographics
NPI:1831600683
Name:CALIMLIM, LUDIVICA
Entity type:Individual
Prefix:
First Name:LUDIVICA
Middle Name:
Last Name:CALIMLIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WEST ARBOR DRIVE # 8501
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-8501
Mailing Address - Country:US
Mailing Address - Phone:858-458-7362
Mailing Address - Fax:619-471-9100
Practice Address - Street 1:200 WEST ARBOR DR #8501
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-8501
Practice Address - Country:US
Practice Address - Phone:858-458-7362
Practice Address - Fax:619-471-9100
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA489948163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management