MEDICARE: DR. CHIE KIGAWA 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	DC31719	CA

General Provider Information

NPI Number	:	1912288119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHIE KIGAWA D.C.

Provider Business Mailing Address
First Line	:	1251 W REDONDO BEACH BLVD
Second Line	:	SUITE 202
City	:	GARDENA
State	:	CA
Zip	:	90247-3456
Country	:	US
Telephone Number	:	310-715-2770
Fax Number	:

Provider Business Practice Location Address
First Line	:	1251 W REDONDO BEACH BLVD
Second Line	:	STE 202
City	:	GARDENA
State	:	CA
Zip	:	90247-3456
Country	:	US
Telephone Number	:	310-715-2770
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2011
Last Update Date	:	08/31/2012

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