Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | 56465 | GA |
Y | 207VE0102X | Reproductive Endocrinologist | MD071623L | PA |
NPI | 1407885114 |
---|---|
Provider Name | Dr. Caleb B. Kallen |
First Address | Philadelphia, PA 19107-5127 |
Second Address | Philadelphia, PA 19107-5127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 09/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H60556 | (02) | GA |