Provider Demographics
NPI:1326886979
Name:CALIMLIM, REX (RN)
Entity type:Individual
Prefix:
First Name:REX
Middle Name:
Last Name:CALIMLIM
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1061 BRIGANTINO DR
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-4290
Mailing Address - Country:US
Mailing Address - Phone:808-220-1853
Mailing Address - Fax:
Practice Address - Street 1:201 9TH ST
Practice Address - Street 2:
Practice Address - City:MARINA
Practice Address - State:CA
Practice Address - Zip Code:93933-6039
Practice Address - Country:US
Practice Address - Phone:831-884-1129
Practice Address - Fax:831-884-1008
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95129956163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care