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NPI Code Detail

MEDICARE: DR. KACI MADDEN DC

MEDICARE:  DR. KACI  MADDEN  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
1111NN0400XNeurology Chiropractor34136CA

General Provider Information

NPI Number : 1346715174
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KACI MADDEN DC
Provider Business Mailing Address
First Line : 5665 OBERLIN DR STE 102
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-1739
Country : US
Telephone Number : 858-859-0530
Fax Number :
Provider Business Practice Location Address
First Line : 5665 OBERLIN DR STE 102
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-1739
Country : US
Telephone Number : 858-859-0530
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2018
Last Update Date : 10/08/2018

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Directions to “ DR. KACI MADDEN DC” Practice Location

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