| Doctor Name: | CALEB ONDIENGA MAUTI |
| NPI Number: | 1053759217 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | BSN: RN |
| License Number: | 726417 |
| Business Practice Address: | 702 W Hamilton Pl Suite 7 San Pedro, CA - 907316372 |
| Business Phone Number: | 3109357969 |
| Business Fax Number: | |
| Mailing Address: | 702 W Hamilton Pl, Suite 7 SAN PEDRO |
| State: | CA |
| Postal Code: | 907316372 |
| Phone Number: | 3109357969 |
| Fax Number: | |
| NPI Enumeration Date: | 06/10/2013 |
| NPI Last Update Date: | 06/10/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0200X |
| License Number: | 726417 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Critical Care Medicine |
| Taxonomy Definition: | |