Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 29279 | AZ |
NPI | 1346234762 |
---|---|
Provider Name | Daniela Caltaru |
First Address | Scottsdale, AZ 85252-8918 |
Second Address | Scottsdale, AZ 85251-6435 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
578859 | (05) | AZ |
AZ 0767730 | BLUE CROSS BLUE SHIELD (01) | AZ |
H39865 | (02) | AZ |