Provider Demographics
NPI:1346263878
Name:KAM, ERNEST S N (DC)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:S N
Last Name:KAM
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 1:13047 ARTESIA BLVD STE C108
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-1369
Mailing Address - Country:US
Mailing Address - Phone:562-402-3397
Mailing Address - Fax:
Practice Address - Street 1:13047 ARTESIA BLVD STE C108
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-1369
Practice Address - Country:US
Practice Address - Phone:562-402-3397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24151111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU65030Medicare UPIN