MEDICARE: DR. ISRAEL CALVA-ROSALES D.C.

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	111NP0017X	Pediatric Chiropractor	34245	CA
2	111NR0400X	Rehabilitation Chiropractor	34245	CA
3	111NS0005X	Sports Physician Chiropractor	34245	CA
4	111NX0800X	Orthopedic Chiropractor	34245	CA
5	111N00000X	Chiropractor	34245	CA

General Provider Information

NPI Number	:	1205329521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ISRAEL CALVA-ROSALES D.C.

Provider Business Mailing Address
First Line	:	1098 FOSTER CITY BLVD STE 203
Second Line	:
City	:	FOSTER CITY
State	:	CA
Zip	:	94404-2345
Country	:	US
Telephone Number	:	650-573-9371
Fax Number	:

Provider Business Practice Location Address
First Line	:	1098 FOSTER CITY BLVD STE 203
Second Line	:
City	:	FOSTER CITY
State	:	CA
Zip	:	94404-2345
Country	:	US
Telephone Number	:	650-573-9371
Fax Number	:

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

Provider Enumeration Date	:	06/11/2018
Last Update Date	:	05/07/2024

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