Provider Demographics
NPI:1124320510
Name:CALDERA, ARCELIA
Entity type:Individual
Prefix:MRS
First Name:ARCELIA
Middle Name:
Last Name:CALDERA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ARCELIA
Other - Middle Name:
Other - Last Name:CALDERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDA
Mailing Address - Street 1:4000 LA RICA AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-3163
Mailing Address - Country:US
Mailing Address - Phone:626-430-9171
Mailing Address - Fax:
Practice Address - Street 1:4000 LA RICA AVE
Practice Address - Street 2:SUITE D
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-3163
Practice Address - Country:US
Practice Address - Phone:626-430-9171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55453126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
15719Other55453