Organization Active NPI

Estelita B. Calica, M.D., Apc.

  • Geriatric Psychiatry Physician
  • Glendale, CA
National Provider Identifier
1366717431
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
C41189 Issued in CA
Legal business name
ESTELITA B. CALICA, M.D., APC.
Practice address
1505 Wilson Ter Ste 230
Glendale, CA 91206-4074
Phone
(818) 546-1515
NPI assigned
Mar 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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

Authorized official

Name
Mr. Andy H Truong
Title
Physician Assistant
Phone
(818) 546-1515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0805X C41189 CA Primary

Addresses

Primary practice location

1505 Wilson Ter Ste 230
Glendale, CA 91206-4074

Mailing address

1505 Wilson Ter Ste 230
Glendale, CA 91206-4074
Phone (818) 546-1515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120402000687 CA Part B Supplier - Clinic/Group Practice 0749440535 Receives reassigned benefits from 1 practitioner
Practice locations: Glendale, CA

National Provider Directory

National Provider Directory

Locations

1505 Wilson Ter
Ste 230
Glendale, CA 91206
Phone (818) 546-1515

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332288000000",
    "number": "1366717431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 WILSON TER STE 230",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064074",
            "telephone_number": "818-546-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 WILSON TER STE 230",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064074",
            "telephone_number": "818-546-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESTELITA B. CALICA, M.D., APC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-21",
        "last_updated": "2012-03-21",
        "status": "A",
        "authorized_official_last_name": "TRUONG",
        "authorized_official_first_name": "ANDY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "818-546-1515",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "CA",
            "license": "C41189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.