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Organization

ASPEN PEDIATRIC CLINIC,INC.

Active
Other names
ASPEN PEDIATRIC CLINIC,INC.
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARCELINO S CALIMLIM JR. M.D. (PRESIDENT)
(760) 951-9985
Entity
Organization

Contact information

Practice address
15203 11TH ST, SUITE C, VICTORVILLE, CA 92395-3737
(760) 951-9985
(760) 952-3387
Mailing address
15203 11TH ST, SUITE C, VICTORVILLE, CA 92395-3737
(760) 951-9985
(760) 952-3387

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A79537
CA
261Q00000X
Clinic/Center
Primary
A79537
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A795370
CA
Enumeration date
12/10/2008
Last updated
03/27/2012
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