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NPI Code Detail

MEDICARE: KEVIN F PRIESTLEY DC

MEDICARE:   KEVIN F PRIESTLEY  DC
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
1111N00000XChiropractor13648CA

General Provider Information

NPI Number : 1033137021
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN F PRIESTLEY DC
Provider Business Mailing Address
First Line : 3 CORPORATE PLAZA DR
Second Line : SUITE 200
City : NEWPORT BEACH
State : CA
Zip : 92660-7905
Country : US
Telephone Number : 949-640-7030
Fax Number : 949-640-0356
Provider Business Practice Location Address
First Line : 3 CORPORATE PLAZA DR
Second Line : SUITE 200
City : NEWPORT BEACH
State : CA
Zip : 92660-7905
Country : US
Telephone Number : 949-640-7030
Fax Number : 949-640-0356
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 12/13/2010

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Directions to “ KEVIN F PRIESTLEY DC” Practice Location

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