Healthcare Provider Details

I. General information

NPI: 1881458172
Provider Name (Legal Business Name): CAULIS HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 02/08/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2680 CROPLEY AVE
SAN JOSE CA
95132-3711
US

IV. Provider business mailing address

2680 CROPLEY AVE
SAN JOSE CA
95132-3711
US

V. Phone/Fax

Practice location:
  • Phone: 669-253-0418
  • Fax:
Mailing address:
  • Phone: 669-253-0418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LI LI
Title or Position: OWNER
Credential:
Phone: 669-253-0418