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NPI Code Detail

MEDICARE: MR. AMILCARE CAVALLINI

MEDICARE: MR. AMILCARE CAVALLINI
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1912107103
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. AMILCARE CAVALLINI
Provider Business Mailing Address
First Line : 2136 EL CAJON BLVD.
Second Line :
City : SAN DIEGO
State : CA
Zip : 92104-1102
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2136 EL CAJON BLVD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92104-1102
Country : US
Telephone Number : 619-291-7375
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2007
Last Update Date : 07/25/2007

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Directions to “ MR. AMILCARE CAVALLINI ” Practice Location

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