Provider Demographics
NPI:1265593776
Name:KEVIN L KALDY DC PC
Entity type:Organization
Organization Name:KEVIN L KALDY DC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:KALDY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-232-4610
Mailing Address - Street 1:PO BOX 642
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93942-0642
Mailing Address - Country:US
Mailing Address - Phone:702-232-4610
Mailing Address - Fax:
Practice Address - Street 1:8821 W SAHARA AVE STE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5893
Practice Address - Country:US
Practice Address - Phone:702-212-3333
Practice Address - Fax:702-212-3300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB929111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100493Medicare UPIN