Provider Demographics
NPI:1194087940
Name:CALVO, CHARLES M II (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:M
Last Name:CALVO
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:50 S STEPHANIE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-5731
Mailing Address - Country:US
Mailing Address - Phone:702-202-4776
Mailing Address - Fax:702-202-6110
Practice Address - Street 1:653 N TOWN CENTER DR STE 518
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-0519
Practice Address - Country:US
Practice Address - Phone:702-369-0200
Practice Address - Fax:702-243-8383
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2024-01-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT10256816-1205207W00000X
NV18303207W00000X, 207WX0107X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1194087940Medicaid