Provider Demographics
NPI:1427364728
Name:KAISER FAMILY MEDICAL MANAGEMENT
Entity Type:Organization
Organization Name:KAISER FAMILY MEDICAL MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:KAISER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:210-545-7000
Mailing Address - Street 1:4095 DE ZAVALA RD
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78249-2066
Mailing Address - Country:US
Mailing Address - Phone:210-545-7000
Mailing Address - Fax:210-545-1177
Practice Address - Street 1:4095 DE ZAVALA RD
Practice Address - Street 2:
Practice Address - City:SHAVANO PARK
Practice Address - State:TX
Practice Address - Zip Code:78249-2066
Practice Address - Country:US
Practice Address - Phone:210-545-7000
Practice Address - Fax:210-545-1177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty