Search › California › 171100000X
Michael Mcculloch, LAC
NPI 1538299029 · on the registry since 2007 · sole proprietor
Practice
- Address
- 124 Pine St
San Anselmo, CA 94960 - Phone
- (415) 407-1357
- Fax
- (415) 485-1065
- Organisation at this address
- Pine Street Clinic Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 171100000X
171100000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California