Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | CPO03662 | |
Y | 222Z00000X | Podiatrist | CPO03662 |
NPI | 1053707901 |
---|---|
Provider Name | Joseph Calcagno |
First Address | Fresno, CA 93720-2686 |
Second Address | Fresno, CA 93720-2686 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2015 |
Last Update Date | 13/12/2017 |