Provider Demographics
NPI:1083868335
Name:REEM, KRISTINE ANNETTE (DC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:ANNETTE
Last Name:REEM
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 1:660 WEST BAKER ST.
Mailing Address - Street 2:STE 327
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626
Mailing Address - Country:US
Mailing Address - Phone:714-751-5170
Mailing Address - Fax:714-751-0134
Practice Address - Street 1:660 WEST BAKER ST
Practice Address - Street 2:STE 327
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626
Practice Address - Country:US
Practice Address - Phone:714-751-5170
Practice Address - Fax:714-751-0134
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22443111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor