Basic Information
| Provider Information | |||||||||
| NPI: | 1912994823 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCCALMONT | ||||||||
| FirstName: | VICKI | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MS, NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14691 CHAPARRAL SLOPE RD | ||||||||
| Address2: | |||||||||
| City: | JAMUL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919353300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6196697663 | ||||||||
| FaxNumber: | 6196697663 | ||||||||
| Practice Location | |||||||||
| Address1: | 7901 FROST ST | ||||||||
| Address2: | SHARP MEMORIAL HEART TRANSPLANT DEPARTMENT | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921232701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8589393831 | ||||||||
| FaxNumber: | 8589394547 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2005 | ||||||||
| LastUpdateDate: | 07/09/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 11951 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 363LA2200X | 11951 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 364S00000X | 1369 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist |
No ID Information.