CHARLES D. CALLERY, M.D., INC (NPI# 1578782066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578782066 |
| Entity Type | Organization |
| Organization Name | CHARLES D. CALLERY, M.D., INC |
| Practice Address |
15725 Pomerado Rd Suite 206 Poway CA 92064-2068 |
| Practice Telephone | 8586750883 |
| Practice Fax Number | 8586750549 |
| Mailing Telephone | 8586750883 |
| Mailing Fax Number | 8586750549 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2008-02-08 |
| Authorized Official Name | DR. CHARLES D CALLERY (OWNER) |
| Authorized Official Telephone | 8586750883 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
G33540 | CA | Ambulatory Health Care Facilities |
| Street Address |
15725 POMERADO RD SUITE 206 |
| City | POWAY |
| State | CA |
| Zip Code | 92064-2068 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710973862 | Maria G. Aceves | Physician Assistant | 15725 Pomerado Rd, Suite 107, Poway, CA 92064-2068 | 2005-09-23 |
| 1649710393 | Brian Lin Quach | Physical Therapist | 15725 Pomerado Rd, Suite 115, Poway, CA 92064-2068 | 2017-02-28 |
| 1649626490 | Valeri Sacknoff D D S Inc | Durable Medical Equipment & Medical Supplies | 15725 Pomerado Rd, Ste 110, Poway, CA 92064-2068 | 2016-05-11 |
| 1699100370 | Heather Preber | Dentist | 15725 Pomerado Rd, Suite 204, Poway, CA 92064-2068 | 2013-09-12 |
| 1164772059 | Benjamin Millard Smith | Physical Therapist | 15725 Pomerado Rd, Suite 115, Poway, CA 92064-2068 | 2012-09-18 |
| 1306134242 | Michelle Joan Schiewe | Physical Therapist | 15725 Pomerado Rd, Suite 106, Poway, CA 92064-2068 | 2011-07-13 |
| 1205163375 | Karen Denise Gold | Physical Therapist | 15725 Pomerado Rd, Suite 106, Poway, CA 92064-2068 | 2009-11-11 |
| 1942400692 | Cpms Medical Group, Inc. | Pain Medicine | 15725 Pomerado Rd, Suite 107, Poway, CA 92064-2068 | 2007-07-20 |
| 1376757625 | E. Stanley Rodier, M.d.,frcpc,inc | Dermatology | 15725 Pomerado Rd, Suite 108, Poway, CA 92064-2068 | 2007-05-09 |
| 1891816658 | Roya Nazila Mirkhan | Dentist | 15725 Pomerado Rd, Suite #200, Poway, CA 92064-2068 | 2007-04-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194357384 | Prabha Choudhary | Student in an Organized Health Care Education/Training Program | 17555, Corte Lomas Verdes, Poway, CA 92064 | 2020-02-06 |
| 1770143968 | Theresa Marie Morales | In Home Supportive Care | 15352 Running Deer Trl, Poway, CA 92064 | 2019-06-19 |
| 1689230997 | Jaclyn Miller | Audiologist | Health Medical Group, 15525 Pomerado Road Suite C-1, Poway, CA 92064 | 2019-05-13 |
| 1205306842 | Angelita Fuentes | Behavior Technician | 12975 Brookprinter Place Suite 250, Poway, CA 92064 | 2018-11-27 |
| 1396235271 | Michael Cutler, M.d., P.C. | Clinic/Center | 12285 Scripps Poway Pkwy Ste 103, Poway, CA 92064 | 2018-05-16 |
| 1720576671 | Jodi A Mcgrady Dmd, Ms, Adc | Dentist | 12350 Oak Knoll Rd, Poway, CA 92064 | 2018-04-26 |
| 1295237139 | Michelle J. Beaupre | Social Worker | 204 Poway Rd., Poway, CA 92064 | 2018-03-07 |
| 1669918165 | Restore Detox Centers | Substance Abuse Rehabilitation Facility | 14099 Sky Mountain Trail, Poway, CA 92064 | 2017-01-09 |
| 1205382561 | Nightingale Meyou | Pharmacist | 5615 Pomerado Rd, Poway, CA 92064 | 2016-08-28 |
| 1578017232 | Elan Lee | Dentist | 13035 Pomerado Road Suite B, Poway, CA 92064 | 2016-08-11 |
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| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356356133 | Inland Valley Surgical Center | Clinic/Center | 15525 Pomerado Rd., Suite E6, Poway, CA 92064 | 2006-07-30 |
| 1972955128 | San Diego Spine & Pain Center, LLC | Clinic/Center | 13029 Pomerado Rd, Suite C, Poway, CA 92064-4246 | 2016-07-11 |
| 1336484096 | Highly Artistic Surgery, Inc | Clinic/Center | 15725 Pomerado Rd Ste 212, Highly Artistic Surgery, Inc, Poway, CA 92064-2060 | 2012-12-06 |
| 1528332087 | Paul Schrupp | Clinic/Center | 15525 Pomerado Rd Ste E6, Poway, CA 92064-2427 | 2012-03-01 |
| 1972749372 | Merton Suzuki Md Inc | Clinic/Center | 12630 Monte Vista Rd, Suite 108, Poway, CA 92064-2530 | 2009-01-06 |
| 1598949281 | Poway Ca Multi Specialty Asc LLC | Clinic/Center | 15525 Pomerado Rd, Suite E-2, Poway, CA 92064-2435 | 2007-12-18 |
| 1700076411 | Philip Wrotslavsky, Dpm, A Professional Corporation | Clinic/Center | 15525 Pomerado Rd, Suite E-6, Poway, CA 92064-2435 | 2007-07-30 |
| 1194770727 | Poway Surgery Center | Clinic/Center | 15525 Pomerado Rd, Suite E2, Poway, CA 92064-2435 | 2006-05-23 |
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| 1861091993 | Willow Vista Surgical Center | Clinic/Center | 39810 Portola Ave, Palm Desert, CA 92260-0624 | 2020-10-20 |
| 1366041469 | The Regents of The University of California | Clinic/Center | 4343 Lankershim Blvd Ste 210, North Hollywood, CA 91602-2705 | 2020-10-20 |
| 1609473420 | Alden Advanced Surgicenter LLC | Clinic/Center | 8741 Alden Drive, Suite B, Los Angeles, CA 90048 | 2020-10-05 |
| 1396352944 | Irvine Surgical Center LLC | Clinic/Center | 17624 Redhill Ave Ste B, Irvine, CA 92614 | 2020-09-28 |
| 1538775267 | Ev Surgery Institute LLC | Clinic/Center | 105 N Bascom Ave Ste 105, San Jose, CA 95128-1811 | 2020-09-18 |
| 1003420001 | On Beach Surgery Center, LLC | Clinic/Center | 5832 Beach Blvd, Suite 210, Buena Park, CA 90621 | 2020-09-07 |
| 1811501661 | Precision Surgical Arts | Clinic/Center | 20311 Sw Birch St Ste 201, Newport Beach, CA 92660-1777 | 2020-08-31 |
| 1205448750 | Elite Surgery Center of South Bay LLC | Clinic/Center | 20528 Hawthorne Blvd Ste 301, Torrance, CA 90503-3202 | 2020-08-17 |
| 1740891571 | Peninsula Surgery Center, LLC | Clinic/Center | 350 Marine Pkwy Ste 100, Redwood City, CA 94065-5224 | 2020-08-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.