MEDICARE: DR. KRISTY CADAVA D.C.

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	22976	CA

General Provider Information

NPI Number	:	1730284035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTY CADAVA D.C.

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	02/03/2015

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