Provider Demographics
NPI:1750867974
Name:KIEN TA CHIROPRACTIC INC
Entity Type:Organization
Organization Name:KIEN TA CHIROPRACTIC INC
Other - Org Name:CK CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:619-280-8383
Mailing Address - Street 1:3902 EL CAJON BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-1016
Mailing Address - Country:US
Mailing Address - Phone:619-283-6615
Mailing Address - Fax:619-283-5772
Practice Address - Street 1:3902 EL CAJON BLVD STE B
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-1016
Practice Address - Country:US
Practice Address - Phone:619-283-6615
Practice Address - Fax:619-283-5772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23384111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty