Organization Active NPI

Raul Calderon MD Inc

  • General Practice Physician
  • Sherman Oaks, CA
National Provider Identifier
1376342931
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
RAUL CALDERON MD INC
Practice address
4955 Van Nuys Blvd Ste 505
Sherman Oaks, CA 91403-1829
Phone
(818) 265-8300
NPI assigned
Mar 7, 2025
Last updated
Apr 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Authorized official

Name
Raul CalderonNPI 1134396492
Title
Owner/MD
Phone
(559) 360-5959

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

4955 Van Nuys Blvd Ste 505
Sherman Oaks, CA 91403-1829

Mailing address

4955 Van Nuys Blvd Ste 505
Sherman Oaks, CA 91403-1829
Phone (818) 265-8300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250512001714 CA Part B Supplier - Clinic/Group Practice 2466979570 Receives reassigned benefits from 1 practitioner
Practice locations: Sherman Oaks, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1741305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1376342931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD STE 505",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031829",
            "telephone_number": "818-265-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD STE 505",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031829",
            "telephone_number": "818-265-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAUL CALDERON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-07",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "CALDERON",
        "authorized_official_first_name": "RAUL",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "559-360-5959"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.