Individual provider Active NPI

Cesar Arturo Calderon, MD

  • General Practice Physician
  • Daytona Beach, FL
National Provider Identifier
1669630422
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
5746 Issued in PR
Practice address
3950 Tiger Bay Rd
Tomoka Correctional Institution Medical Dept
Daytona Beach, FL 32124-1098
Phone
(386) 323-1120
Fax
(386) 323-1168
NPI assigned
May 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 5746 PR Primary
General Practice Physician 208D00000X ACN63 FL

Addresses

Primary practice location

3950 Tiger Bay Rd
Tomoka Correctional Institution Medical Dept
Daytona Beach, FL 32124-1098

Mailing address

3950 Tiger Bay Rd
Medical Tomoka Correctional Institution
Daytona Beach, FL 32124-1098
Phone (386) 323-1120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5746PRMDPsychologist
ACN63FLMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1669630422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 TIGER BAY RD",
            "address_2": "MEDICAL TOMOKA CORRECTIONAL INSTITUTION",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321241098",
            "telephone_number": "386-323-1120",
            "fax_number": "386-323-1168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 TIGER BAY RD",
            "address_2": "TOMOKA CORRECTIONAL INSTITUTION MEDICAL DEPT",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321241098",
            "telephone_number": "386-323-1120",
            "fax_number": "386-323-1168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "CESAR",
        "middle_name": "ARTURO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "5746",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN63",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.