# EILEEN R KALK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1538268016
- **Gender:** F
- **Credential:** PA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | PT10212 | CA | — |
| 363A00000X | Physician Assistant | 17682 | CA | Yes |

## Other

- **Enumeration date:** 09/21/2006
- **Last updated:** 12/14/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 17682 | PA LICENSE NUMBER | CA |