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General NPI Number Information
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NPI Number | 1710206040
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Entity Type | Organization
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Legal Business Name | MORELLO FAMILY CHIROPRACTIC, INC
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Dates
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Enumeration Date | 05/26/2010
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Last Update Date | 05/26/2010
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Provider Practice Location Address
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Address Line | 1177 MISSION RD STE C
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080-7702
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Country | US
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Telephone | 650-225-9900
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Fax |
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Provider Business Mailing Address
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Address Line | 1177 MISSION RD STE C
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080-7702
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Country | US
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Telephone | 650-225-9900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NATHAN MORELLO
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Credential | D.C.
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Telephone | 650-225-9900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC29332
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License Number State | CA
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