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NPI Code Detail

MEDICARE: KYLE TAKETA CHIROPRACTIC INCORPORATED

MEDICARE: KYLE TAKETA CHIROPRACTIC INCORPORATED
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
1111N00000XChiropractor

General Provider Information

NPI Number : 1992570774
Entity Type Code : Organization
Provider Name (Legal Business Name) : KYLE TAKETA CHIROPRACTIC INCORPORATED
Provider Business Mailing Address
First Line : 190 W 25TH AVE STE 4
Second Line :
City : SAN MATEO
State : CA
Zip : 94403-2272
Country : US
Telephone Number : 650-349-2222
Fax Number : 650-341-3415
Provider Business Practice Location Address
First Line : 190 W 25TH AVE STE 4
Second Line :
City : SAN MATEO
State : CA
Zip : 94403-2272
Country : US
Telephone Number : 650-349-2222
Fax Number : 650-341-3415
Authorized Official
Title or Position : OWNER
Name : DR. KYLE HITOSHI TAKETA
Credential : DC
Telephone Number : 650-349-2222
Provider Enumeration Date : 11/21/2023
Last Update Date : 11/21/2023

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Directions to “KYLE TAKETA CHIROPRACTIC INCORPORATED ” Practice Location

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