Provider Demographics
NPI:1700960242
Name:KAM, FRANKLIN SAU SAN (DC)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:SAU SAN
Last Name:KAM
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 1:3859 SAN AUGUSTINE DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-1230
Mailing Address - Country:US
Mailing Address - Phone:818-952-1020
Mailing Address - Fax:818-500-9036
Practice Address - Street 1:230 N MARYLAND AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4261
Practice Address - Country:US
Practice Address - Phone:818-500-9440
Practice Address - Fax:818-500-9036
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC13566111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT17537Medicare UPIN
CADC13566Medicare ID - Type Unspecified