Provider Demographics
NPI:1427250844
Name:CALMA, CAROLYN SY (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:SY
Last Name:CALMA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13836 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-9042
Mailing Address - Country:US
Mailing Address - Phone:714-670-8615
Mailing Address - Fax:714-670-8615
Practice Address - Street 1:14642 NEWPORT AVE
Practice Address - Street 2:STE. 330
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6057
Practice Address - Country:US
Practice Address - Phone:714-508-0754
Practice Address - Fax:714-508-5754
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14797363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant