Healthcare Provider Details

I. General information

NPI: 1609842145
Provider Name (Legal Business Name): CALI CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 12/17/2020
Certification Date: 12/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 E VALLEY RD SUITE 105
BASALT CO
81621-8352
US

IV. Provider business mailing address

1450 E VALLEY RD SUITE 105 ALL VALLEY WOMENS CARE
BASALT CO
81621-8352
US

V. Phone/Fax

Practice location:
  • Phone: 970-927-1717
  • Fax: 970-927-6164
Mailing address:
  • Phone: 970-927-1717
  • Fax: 970-927-6164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MELINDA L NAGLE
Title or Position: OWNER
Credential: MD
Phone: 970-927-1717