Provider Demographics
NPI:1174686596
Name:CATER, KIMBLE T (DC)
Entity Type:Individual
Prefix:MR
First Name:KIMBLE
Middle Name:T
Last Name:CATER
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 1:1211 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-2826
Mailing Address - Country:US
Mailing Address - Phone:831-449-2225
Mailing Address - Fax:831-449-2377
Practice Address - Street 1:1211 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-2826
Practice Address - Country:US
Practice Address - Phone:831-449-2225
Practice Address - Fax:831-449-2377
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15161111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA260051222OtherTAX ID
CA260051222OtherTAX ID