Provider Demographics
NPI:1508363953
Name:HUNSAKER, KYLIE (DC)
Entity Type:Individual
Prefix:
First Name:KYLIE
Middle Name:
Last Name:HUNSAKER
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 1:235 HELIOTROPE AVE
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-3222
Mailing Address - Country:US
Mailing Address - Phone:949-441-9704
Mailing Address - Fax:
Practice Address - Street 1:22362 GILBERTO STE 250
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-2143
Practice Address - Country:US
Practice Address - Phone:949-441-9704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34091111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor