OrganizationJonathan CallerosDentistDental ProvidersPractice AddressPaseo De Los Heroes 9211 Ste 110, Tijuana, Baja California 22010 (Mexico)(619) 488-3200PECOS EnrollmentBased on the most recent information from CMS, provider Jonathan Calleros does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1699314625Provider TypeOrganizationFull NameJonathan CallerosSubpartNoEnumeration Date12/20/2019Last Updated12/20/2019Contact InformationPractice LocationPractice AddressPaseo De Los Heroes 9211 Ste 110, Tijuana, Baja California 22010 (Mexico)Phone(619) 488-3200Fax(866) 272-6924Mailing LocationMailing Address4275 Executive Sq Ste 200, La Jolla, CA 92037-1476PhoneUnlisted PhoneFaxUnlisted FaxAuthorized OfficialNameCalleros, Jonathan (Dentist)Phone(619) 488-3200Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicenseUnlisted Issuer