Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | G78977 | CA |
NPI | 1154316099 |
---|---|
Provider Name | Rocco Richard Calderone |
First Address | Camarillo, CA 93010-2469 |
Second Address | Camarillo, CA 93010-2469 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2005 |
Last Update Date | 24/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F87246 | (02) | CA |