Provider Demographics
NPI:1023117892
Name:KISER, PATRICIA M (DC)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:M
Last Name:KISER
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 1:540 BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-1742
Mailing Address - Country:US
Mailing Address - Phone:650-326-9812
Mailing Address - Fax:
Practice Address - Street 1:326 BRYANT ST
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-1407
Practice Address - Country:US
Practice Address - Phone:650-326-9812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23867111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0238670Medicare ID - Type Unspecified