Healthcare Provider Details

I. General information

NPI: 1649399015
Provider Name (Legal Business Name): HOWARD KWASMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 01/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20825 SOUTH ST
TEHACHAPI CA
93561-6438
US

IV. Provider business mailing address

20825 SOUTH ST
TEHACHAPI CA
93561-6438
US

V. Phone/Fax

Practice location:
  • Phone: 661-823-8888
  • Fax:
Mailing address:
  • Phone: 661-823-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC 18489
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: