MEDICARE: KRISTY CADAVA, D.C. A CHIROPRACTIC CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	22876	CA

General Provider Information

NPI Number	:	1619092921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KRISTY CADAVA, D.C. A CHIROPRACTIC CORPORATION

Provider Business Mailing Address
First Line	:	1676 PALM AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92154-1027
Country	:	US
Telephone Number	:	619-423-3217
Fax Number	:	619-423-8619

Provider Business Practice Location Address
First Line	:	1676 PALM AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92154-1027
Country	:	US
Telephone Number	:	619-423-3217
Fax Number	:	619-423-8619

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KRISTY CADAVA
Credential	:	D.C.
Telephone Number	:	619-423-3217

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	02/18/2015

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