Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0900X | Dermatopathologist | A84455 | CA |
N | 207ND0900X | Dermatopathologist | M7845 | TX |
NPI | 1285817569 |
---|---|
Provider Name | Antoanella Calame |
First Address | San Diego, CA 92121-2253 |
Second Address | San Diego, CA 92121-2253 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2007 |
Last Update Date | 21/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DW536Z | MEDICARE PTAN (01) | CA |