MEDICARE: DR. DAVID M KALLINGER PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PSY13868	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023109055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID M KALLINGER PHD

Provider Business Mailing Address
First Line	:	2433 CARLETON ST
Second Line	:	SUITE A
City	:	BERKELEY
State	:	CA
Zip	:	94704-3327
Country	:	US
Telephone Number	:	510-845-1363
Fax Number	:

Provider Business Practice Location Address
First Line	:	2433 CARLETON ST
Second Line	:	SUITE A
City	:	BERKELEY
State	:	CA
Zip	:	94704-3327
Country	:	US
Telephone Number	:	510-845-1363
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/09/2007

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