Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0117X | Orthopaedic Spine Surgeon | 0101256557 | VA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 54025 | AZ |
NPI | 1215109673 |
---|---|
Provider Name | Caleb J. Behrend |
First Address | Salt Lake City, UT 84127-1429 |
Second Address | Gilbert, AZ 85234-2171 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2008 |
Last Update Date | 03/12/2018 |