Provider Demographics
NPI:1982649109
Name:GILJUM, KARL ANTHONY (DC)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:ANTHONY
Last Name:GILJUM
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 1:500 SUTTER ST
Mailing Address - Street 2:#601
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-1107
Mailing Address - Country:US
Mailing Address - Phone:415-706-1920
Mailing Address - Fax:415-421-8228
Practice Address - Street 1:500 SUTTER ST
Practice Address - Street 2:#601
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1107
Practice Address - Country:US
Practice Address - Phone:415-706-1920
Practice Address - Fax:415-421-8228
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC18228111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0182281Medicare ID - Type Unspecified