Provider Demographics
NPI:1972680528
Name:MCCAULEY, PATRICK BRIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:BRIAN
Last Name:MCCAULEY
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 1:856 W EL CAMINO REAL
Mailing Address - Street 2:SUITE D
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-2593
Mailing Address - Country:US
Mailing Address - Phone:650-938-3737
Mailing Address - Fax:650-967-2683
Practice Address - Street 1:856 W EL CAMINO REAL
Practice Address - Street 2:SUITE D
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-2593
Practice Address - Country:US
Practice Address - Phone:650-938-3737
Practice Address - Fax:650-967-2683
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-29357111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADCO29357OMedicare ID - Type Unspecified