Provider Demographics
NPI:1588800692
Name:KERWIN, STEN STENSGAARD (DC)
Entity Type:Individual
Prefix:DR
First Name:STEN
Middle Name:STENSGAARD
Last Name:KERWIN
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 1:27131 CALLE ARROYO
Mailing Address - Street 2:1702
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-2700
Mailing Address - Country:US
Mailing Address - Phone:949-485-2920
Mailing Address - Fax:949-489-3749
Practice Address - Street 1:27131 CALLE ARROYO
Practice Address - Street 2:1702
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-2700
Practice Address - Country:US
Practice Address - Phone:949-485-2920
Practice Address - Fax:949-489-3749
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29306111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor