Provider Demographics
NPI:1740480698
Name:DARK & KAIBEL, D.C.'S
Entity type:Organization
Organization Name:DARK & KAIBEL, D.C.'S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:DARK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:951-845-1931
Mailing Address - Street 1:851 E. 6TH STREET
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-2217
Mailing Address - Country:US
Mailing Address - Phone:951-845-1931
Mailing Address - Fax:951-845-0557
Practice Address - Street 1:851 E. 6TH STREET
Practice Address - Street 2:SUITE B-1
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-2217
Practice Address - Country:US
Practice Address - Phone:951-845-1931
Practice Address - Fax:951-845-0557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11294111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ133347ZMedicare UPIN