Provider Demographics
NPI:1174908149
Name:CALDERON, VICTOR MANUEL JR (OD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:MANUEL
Last Name:CALDERON
Suffix:JR
Gender:M
Credentials:OD
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Mailing Address - Street 1:1502 N TUCSON BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-3423
Mailing Address - Country:US
Mailing Address - Phone:520-326-4321
Mailing Address - Fax:
Practice Address - Street 1:9515 W CAMELBACK RD STE 110
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-1365
Practice Address - Country:US
Practice Address - Phone:623-937-1655
Practice Address - Fax:623-930-1396
Is Sole Proprietor?:No
Enumeration Date:2015-07-20
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ2079152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist