Daniel Calderon, SO-ATP

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

Practice address

1253 Makalapa Gate Rd BLDG 1407
Jbphh, HI 96860-4479

Phone

(201) 888-4733

NPI assigned

Oct 7, 2021

Last updated

Oct 7, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1174285092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "962 ALIAMANU DR",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968187089",
            "telephone_number": "201-888-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1253 MAKALAPA GATE RD BLDG 1407",
            "city": "JBPHH",
            "state": "HI",
            "postal_code": "968604479",
            "telephone_number": "201-888-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "DANIEL",
        "credential": "SO-ATP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "TX",
            "license": "E1840660",
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Brook, IDMT
• Traci L. Brooks, RN, FNP-C
• James Bustamante
• Cory John Butler, IDC
• Daryl R Cadelina, RN
• Ka'Dira Carey, LCSW
• Alec James Carlson, IDC
• Rachel Helen Carlson, DO
• Erin Iwalani Castillo, LCSW
• Erin Caula, LCSW

• Military Health Care Provider in Jbphh, HI
• Providers in Jbphh, HI by specialty
• Military Health Care Provider in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.