Provider Demographics
NPI:1912239500
Name:KAY, SAMUEL (DC)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:KAY
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 1:14245 LORA DR APT 11
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1235
Mailing Address - Country:US
Mailing Address - Phone:408-460-9410
Mailing Address - Fax:
Practice Address - Street 1:14245 LORA DR APT 11
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1235
Practice Address - Country:US
Practice Address - Phone:408-460-9410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24439111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor