Provider Demographics
NPI:1932935061
Name:JEANIESAR CALUAG MD INC.
Entity type:Organization
Organization Name:JEANIESAR CALUAG MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANIESAR
Authorized Official - Middle Name:BRAWNER
Authorized Official - Last Name:CALUAG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-615-2534
Mailing Address - Street 1:31 JULIANNA AVE
Mailing Address - Street 2:
Mailing Address - City:MOSS BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:94038-9648
Mailing Address - Country:US
Mailing Address - Phone:415-615-2534
Mailing Address - Fax:833-643-0160
Practice Address - Street 1:31 JULIANNA AVENUE
Practice Address - Street 2:
Practice Address - City:MOSS BEACH
Practice Address - State:CA
Practice Address - Zip Code:94038
Practice Address - Country:US
Practice Address - Phone:415-615-2534
Practice Address - Fax:183-364-3016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty