Provider Demographics
NPI:1063201507
Name:CALDERON MEDICAL CORPORATION
Entity type:Organization
Organization Name:CALDERON MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:GABRIELA
Authorized Official - Last Name:CALDERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-649-8302
Mailing Address - Street 1:7862 LANKERSHIM AVE APT 106
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-4000
Mailing Address - Country:US
Mailing Address - Phone:909-649-8302
Mailing Address - Fax:909-649-8302
Practice Address - Street 1:7862 LANKERSHIM AVE APT 106
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-4000
Practice Address - Country:US
Practice Address - Phone:909-649-8302
Practice Address - Fax:909-649-8302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)