# EDYE A CALDERON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1669577474
- **Gender:** F
- **Credential:** PAC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 1645 | OK | Yes |
| 363AM0700X | Medical Physician Assistant | 2868 | AZ | — |
| 363AS0400X | Surgical Physician Assistant | 2868 | AZ | — |

## Other

- **Enumeration date:** 09/14/2006
- **Last updated:** 08/13/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200116340A | — | OK |
| 01 | — | 242722104 | MEDICARE | OK |
| 05 | — | 816176 | — | AZ |