Provider Demographics
NPI:1508931460
Name:KALLOP, KOEN P (DC)
Entity Type:Individual
Prefix:DR
First Name:KOEN
Middle Name:P
Last Name:KALLOP
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 1:10162 ALPINE DR
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-0942
Mailing Address - Country:US
Mailing Address - Phone:650-787-7328
Mailing Address - Fax:
Practice Address - Street 1:1309 S MARY AVE STE 100
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3053
Practice Address - Country:US
Practice Address - Phone:408-733-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor