Provider Demographics
NPI:1073509873
Name:CALL, GREGORY ELLIS (DC)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:ELLIS
Last Name:CALL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 SYCAMORE VALLEY RD W
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-3947
Mailing Address - Country:US
Mailing Address - Phone:925-837-5595
Mailing Address - Fax:925-837-6558
Practice Address - Street 1:565 SYCAMORE VALLEY RD W
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-3900
Practice Address - Country:US
Practice Address - Phone:925-837-5595
Practice Address - Fax:925-837-6558
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-27
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15878111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U18613Medicare UPIN
CADC0158780Medicare ID - Type Unspecified