Provider Demographics
NPI:1407890825
Name:GLOVER, CATHY ANN HUNTER (DC)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:ANN HUNTER
Last Name:GLOVER
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 1:2659 KADOTA ST
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-2446
Mailing Address - Country:US
Mailing Address - Phone:805-577-7503
Mailing Address - Fax:805-520-2948
Practice Address - Street 1:2659 KADOTA ST
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-2446
Practice Address - Country:US
Practice Address - Phone:805-577-7503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC25341Medicare UPIN