Provider Demographics
NPI:1912440587
Name:KAYKOV, ALEXSANDRA (DC)
Entity Type:Individual
Prefix:
First Name:ALEXSANDRA
Middle Name:
Last Name:KAYKOV
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 1:4705 KESTER AVE
Mailing Address - Street 2:109
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2001
Mailing Address - Country:US
Mailing Address - Phone:818-648-9606
Mailing Address - Fax:
Practice Address - Street 1:5142 LAUREL CANYON BLVD
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3134
Practice Address - Country:US
Practice Address - Phone:818-927-3777
Practice Address - Fax:818-301-1915
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-29
Last Update Date:2020-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33327111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor