Provider Demographics
NPI:1780750984
Name:KIRKWOOD, PAMELA W (DC)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:W
Last Name:KIRKWOOD
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 1:784 NORTHRIDGE
Mailing Address - Street 2:SUITE 175
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906
Mailing Address - Country:US
Mailing Address - Phone:831-443-1222
Mailing Address - Fax:831-443-0732
Practice Address - Street 1:1164 MONROE ST.
Practice Address - Street 2:SUITE 1
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906
Practice Address - Country:US
Practice Address - Phone:831-443-1222
Practice Address - Fax:831-443-0732
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC18122111N00000X
CA18122111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0181220Medicare PIN
CADC0181220Medicare ID - Type Unspecified
CAU25583Medicare UPIN