Healthcare Provider Details

I. General information

NPI: 1215398490
Provider Name (Legal Business Name): DR. ALEXIS CALCANO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1152 SOLANO AVE STE A
ALBANY CA
94706-1638
US

IV. Provider business mailing address

631 LIBERTY ST APT 4
EL CERRITO CA
94530-3179
US

V. Phone/Fax

Practice location:
  • Phone: 510-384-8570
  • Fax:
Mailing address:
  • Phone: 510-845-2341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number16678
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: