MEDICARE: DR. MARTA CALLOTTA DC

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	111N00000X	Chiropractor	DC24681	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC24681	OTHER	CA	LICENSE #

General Provider Information

NPI Number	:	1750559175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTA CALLOTTA DC

Provider Business Mailing Address
First Line	:	3434 N LOS COYOTES DIAGONAL
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-2915
Country	:	US
Telephone Number	:	562-938-8770
Fax Number	:	562-938-8762

Provider Business Practice Location Address
First Line	:	3434 N LOS COYOTES DIAGONAL
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-2915
Country	:	US
Telephone Number	:	562-938-8770
Fax Number	:	562-938-8762

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

Provider Enumeration Date	:	02/19/2008
Last Update Date	:	02/19/2008

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Directions to “ DR. MARTA CALLOTTA DC” Practice Location

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