Provider Demographics
NPI:1023040516
Name:MIGOTTI, KEITH THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:THOMAS
Last Name:MIGOTTI
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 1:28 QUAIL RUN CIR STE A
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93907-2350
Mailing Address - Country:US
Mailing Address - Phone:831-757-9420
Mailing Address - Fax:831-757-2119
Practice Address - Street 1:28 QUAIL RUN CIR STE A
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93907-2350
Practice Address - Country:US
Practice Address - Phone:831-757-9420
Practice Address - Fax:831-757-2119
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16744111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADCO16744Medicare ID - Type Unspecified