Provider Demographics
NPI:1699911487
Name:CALLAN, THOMAS WILLIAM I (M D)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WILLIAM
Last Name:CALLAN
Suffix:I
Gender:M
Credentials:M D
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 904
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92022-0904
Mailing Address - Country:US
Mailing Address - Phone:619-440-4421
Mailing Address - Fax:619-593-2120
Practice Address - Street 1:230 CAJON VIEW DR
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-7502
Practice Address - Country:US
Practice Address - Phone:619-440-4421
Practice Address - Fax:619-593-2120
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-28
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAGFE26074207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGFE26074OtherCALIFORIA MEDICAL LIC. GFE26074; DEA AC6108890
CAGFE26074Medicare PIN