Provider Demographics
NPI:1508946575
Name:KENDIG, ARMEN R (DC)
Entity Type:Individual
Prefix:DR
First Name:ARMEN
Middle Name:R
Last Name:KENDIG
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 1:19881 HIGHWAY 88
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PINE GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95665
Mailing Address - Country:US
Mailing Address - Phone:209-296-1122
Mailing Address - Fax:209-296-1142
Practice Address - Street 1:19881 HIGHWAY 88
Practice Address - Street 2:SUITE 1
Practice Address - City:PINE GROVE
Practice Address - State:CA
Practice Address - Zip Code:95665
Practice Address - Country:US
Practice Address - Phone:209-296-1122
Practice Address - Fax:209-296-1142
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13430111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADCO134300Medicare ID - Type UnspecifiedPROVIDER ID #