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General NPI Number Information
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NPI Number | 1598657454
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Entity Type | Individual
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Provider Name | MARC CHRISTIAN CALLEJO MOLINA
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Gender | Male
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 220 EDMONDS RD
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City | REDWOOD CITY
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State | CA
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Zip | 94062-3813
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Country | US
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Telephone | 650-367-1890
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Fax | 650-369-6465
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Provider Business Mailing Address
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Address Line | 127 36TH AVE
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City | SAN MATEO
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State | CA
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Zip | 94403-4402
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Country | US
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Telephone | 650-766-8417
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 276750
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License Number State | CA
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