Healthcare Provider Details

I. General information

NPI: 1922938349
Provider Name (Legal Business Name): KALA PETERSON CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7290 NAVAJO RD STE 109
SAN DIEGO CA
92119-1631
US

IV. Provider business mailing address

7290 NAVAJO RD STE 109
SAN DIEGO CA
92119-1631
US

V. Phone/Fax

Practice location:
  • Phone: 619-320-5639
  • Fax:
Mailing address:
  • Phone: 619-320-5639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: KALA MARIE PETERSON
Title or Position: OWNER
Credential: DC
Phone: 772-494-9459