Provider Demographics
NPI:1780602383
Name:BARKALOW, STEPHEN DEREK (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:DEREK
Last Name:BARKALOW
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 1:550 CAMINO EL ESTERO
Mailing Address - Street 2:STE 204
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3231
Mailing Address - Country:US
Mailing Address - Phone:831-375-5151
Mailing Address - Fax:831-375-6682
Practice Address - Street 1:550 CAMINO EL ESTERO
Practice Address - Street 2:STE 204
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3231
Practice Address - Country:US
Practice Address - Phone:831-375-5151
Practice Address - Fax:831-375-6682
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC11690111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT04449Medicare UPIN
CADC0116900Medicare ID - Type Unspecified