Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | D10187 | OR |
NPI | 1053533745 |
---|---|
Provider Name | Joseph Vincent Califano |
First Address | Portland, OR 97201-5042 |
Second Address | Portland, OR 97201-5042 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 08/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1053533745 | NPI (01) |