Provider Demographics
NPI:1912288119
Name:KIGAWA, CHIE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHIE
Middle Name:
Last Name:KIGAWA
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 1:1251 W REDONDO BEACH BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-3456
Mailing Address - Country:US
Mailing Address - Phone:310-715-2770
Mailing Address - Fax:
Practice Address - Street 1:1251 W REDONDO BEACH BLVD
Practice Address - Street 2:STE 202
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-3456
Practice Address - Country:US
Practice Address - Phone:310-715-2770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31719111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor