Provider Demographics
NPI:1649288697
Name:MORELLO, NATHAN (DC)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:
Last Name:MORELLO
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1177 MISSION RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-1302
Mailing Address - Country:US
Mailing Address - Phone:650-225-9900
Mailing Address - Fax:650-225-9905
Practice Address - Street 1:1177 MISSION RD
Practice Address - Street 2:SUITE C
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-1302
Practice Address - Country:US
Practice Address - Phone:650-225-9900
Practice Address - Fax:650-225-9905
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29332111N00000X
CA95033493363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor