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NPI Code Detail

MEDICARE: NOEL CARCALLAS CABRERA

MEDICARE: NOEL CARCALLAS CABRERA
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
1225200000XPhysical Therapy Assistant9738CA

General Provider Information

NPI Number : 1275270795
Entity Type Code : Individual
Provider Name (Legal Business Name) : NOEL CARCALLAS CABRERA
Provider Business Mailing Address
First Line : 890 EL CAMINO REAL
Second Line :
City : SAN BRUNO
State : CA
Zip : 94066-3137
Country : US
Telephone Number : 650-583-7768
Fax Number :
Provider Business Practice Location Address
First Line : 890 EL CAMINO REAL
Second Line :
City : SAN BRUNO
State : CA
Zip : 94066-3137
Country : US
Telephone Number : 650-583-7768
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2022
Last Update Date : 06/06/2022

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Directions to “ NOEL CARCALLAS CABRERA ” Practice Location

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