Provider Demographics
NPI:1801074471
Name:LINDQUIST, KEVIN PARKER (DC)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:PARKER
Last Name:LINDQUIST
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 1:2588 EL CAMINO REAL
Mailing Address - Street 2:F235
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1211
Mailing Address - Country:US
Mailing Address - Phone:760-434-4333
Mailing Address - Fax:760-529-9580
Practice Address - Street 1:1207 CARLSBAD VILLAGE DR
Practice Address - Street 2:SUITE S
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1957
Practice Address - Country:US
Practice Address - Phone:760-434-4333
Practice Address - Fax:760-529-9580
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21408111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU21983Medicare UPIN