Provider Demographics
NPI:1548368665
Name:CALICA, ESTELITA B (MD)
Entity type:Individual
Prefix:
First Name:ESTELITA
Middle Name:B
Last Name:CALICA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1505 WILSON TER
Mailing Address - Street 2:SUITE #230
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4071
Mailing Address - Country:US
Mailing Address - Phone:818-546-1515
Mailing Address - Fax:818-546-1650
Practice Address - Street 1:1505 WILSON TER
Practice Address - Street 2:SUITE #230
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4071
Practice Address - Country:US
Practice Address - Phone:818-546-1515
Practice Address - Fax:818-546-1650
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2019-05-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC411892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA37548Medicare UPIN
CAC41189Medicare PIN