Provider Demographics
NPI:1730201377
Name:GYNECOLOGY CARE CENTER
Entity type:Organization
Organization Name:GYNECOLOGY CARE CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CALDERON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-424-9989
Mailing Address - Street 1:765 MEDICAL CENTER CT
Mailing Address - Street 2:SUITE 209
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-6600
Mailing Address - Country:US
Mailing Address - Phone:760-424-9989
Mailing Address - Fax:
Practice Address - Street 1:765 MEDICAL CENTER CT
Practice Address - Street 2:SUITE 209
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6600
Practice Address - Country:US
Practice Address - Phone:760-424-9989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty