Healthcare Provider Details

I. General information

NPI: 1871729541
Provider Name (Legal Business Name): KANDACE MARIE GEE B.S., D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2009
Last Update Date: 08/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 DAVIS DR
FALLBROOK CA
92028-1812
US

IV. Provider business mailing address

31915 RANCHO CALIFORNIA RD SUITE 200-266
TEMECULA CA
92591-2998
US

V. Phone/Fax

Practice location:
  • Phone: 951-588-4214
  • Fax:
Mailing address:
  • Phone: 951-588-4214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC 30418
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: