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Individual
EILEEN R KALK
Active
Individual
EILEEN R KALK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT10212
CA
363A00000X
Physician Assistant
Primary
17682
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17682
PA LICENSE NUMBER
CA
Enumeration date
09/21/2006
Last updated
12/14/2012
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