Healthcare Provider Details

I. General information

NPI: 1013075340
Provider Name (Legal Business Name): JULIANO CALLACI DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 06/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 CAPITOLA AVE STE A
CAPITOLA CA
95010-2777
US

IV. Provider business mailing address

716 CAPITOLA AVE STE A
CAPITOLA CA
95010-2777
US

V. Phone/Fax

Practice location:
  • Phone: 831-479-1213
  • Fax: 831-479-1016
Mailing address:
  • Phone: 831-479-1213
  • Fax: 831-479-1016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC27727
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: