Provider Demographics
NPI:1215109673
Name:BEHREND, CALEB J (MD)
Entity type:Individual
Prefix:
First Name:CALEB
Middle Name:J
Last Name:BEHREND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 271429
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-1429
Mailing Address - Country:US
Mailing Address - Phone:602-772-3800
Mailing Address - Fax:602-772-3801
Practice Address - Street 1:2940 E BANNER GATEWAY DR STE 200
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2171
Practice Address - Country:US
Practice Address - Phone:480-964-2908
Practice Address - Fax:480-833-2136
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101256557207XS0117X, 207XS0117X
AZ54025207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1215109673OtherVA PREMIER
VA1215109673OtherCIGNA
VA1215109673OtherANTHEM BCBS
VA1215109673OtherHUMANA MEDICARE
VA1215109673OtherSOUTHERN HEALTH/CARENET/CARELINK/COVENTRY
VA1215109673OtherOPTIMA HEALTH PLAN
VA1215109673OtherUNITED HEALTHCARE
VA1215109673OtherVIRGINIA HEALTH NETWORK
VA1215109673OtherINTOTAL
VA540506332199OtherTRICARE
VAVVE095AOtherMEDICARE
VA1215109673OtherVA MEDICAID
VA1215109673OtherUMWA
VA1215109673OtherHEALTHKEEPERS PLUS
VA1215109673OtherAETNA
VA3810029625OtherMEDICAID OF WEST VA
VA1215109673OtherGATEWAY
VA1215109673OtherHEALTHKEEPERS
VAP01349428OtherRAILROAD MEDICARE