Provider Demographics
NPI:1841363256
Name:CALLAHAN, DEBRA D (DC)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:D
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4247 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3705
Mailing Address - Country:US
Mailing Address - Phone:808-644-6447
Mailing Address - Fax:805-644-3430
Practice Address - Street 1:4247 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3705
Practice Address - Country:US
Practice Address - Phone:808-644-6447
Practice Address - Fax:805-644-3430
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC18707111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT18720Medicare UPIN