Provider Demographics
NPI:1871701250
Name:CALALB, MIHAIL BUCUR (LAC)
Entity type:Individual
Prefix:
First Name:MIHAIL
Middle Name:BUCUR
Last Name:CALALB
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 BISCAYNE CT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-2506
Mailing Address - Country:US
Mailing Address - Phone:303-315-8915
Mailing Address - Fax:303-315-3261
Practice Address - Street 1:1330 SUNSET ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3218
Practice Address - Country:US
Practice Address - Phone:303-776-0333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO554171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist