Provider Demographics
NPI:1790790368
Name:KALMBACH, FREDERICK N (DC)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:N
Last Name:KALMBACH
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 1:2779 BECHELLI LN
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-1924
Mailing Address - Country:US
Mailing Address - Phone:530-722-9010
Mailing Address - Fax:530-722-9013
Practice Address - Street 1:2779 BECHELLI LN
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-1924
Practice Address - Country:US
Practice Address - Phone:530-722-9010
Practice Address - Fax:530-722-9013
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 26742111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0267420Medicare ID - Type Unspecified
U80609Medicare UPIN