Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | A23437 | CA |
N | 207R00000X | Internist | A23437 | CA |
N | 111NI0900X | Internist | A23437 | CA |
NPI | 1134104581 |
---|---|
Provider Name | Dr. Robert Calson |
First Address | Ukiah, CA 95482-2739 |
Second Address | Ukiah, CA 95482-4533 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2005 |
Last Update Date | 20/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A234370 | (05) | CA |
A23541 | (02) | CA |