Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 34245 | CA |
N | 111NP0017X | Pediatric Chiropractor | 34245 | CA |
N | 111NR0400X | Rehabilitation Chiropractor | 34245 | CA |
N | 111NS0005X | Chiropractic Sports Physician | 34245 | CA |
NPI | 1205329521 |
---|---|
Provider Name | Dr. Israel Calva-Rosales |
First Address | Foster City, CA 94404-2345 |
Second Address | Foster City, CA 94404-2345 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2018 |
Last Update Date | 24/03/2020 |