Provider Demographics
NPI:1801897749
Name:TOY, KENNETH MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:MICHAEL
Last Name:TOY
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 1:30630 RANCHO CALIFORNIA RD
Mailing Address - Street 2:#F501
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-3283
Mailing Address - Country:US
Mailing Address - Phone:951-694-6350
Mailing Address - Fax:951-694-6353
Practice Address - Street 1:30630 RANCHO CALIFORNIA RD
Practice Address - Street 2:#F501
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-3283
Practice Address - Country:US
Practice Address - Phone:951-694-6350
Practice Address - Fax:951-694-6353
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19635111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor