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Individual
EDYE A CALDERON
Active
Individual
EDYE A CALDERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1645
OK
363AM0700X
Medical Physician Assistant
2868
AZ
363AS0400X
Surgical Physician Assistant
2868
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200116340A
—
OK
01
—
242722104
MEDICARE
OK
05
—
816176
—
AZ
Enumeration date
09/14/2006
Last updated
08/13/2008
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