MEDICARE: KAITLIN DICK 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
1	111N00000X	Chiropractor	36138	CA

General Provider Information

NPI Number	:	1467120162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLIN DICK DC

Provider Business Mailing Address
First Line	:	11301 WILSHIRE BLVD
Second Line	:	BUILDING 304, ROOM 3-113
City	:	LOS ANGELES
State	:	CA
Zip	:	90073-1003
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11301 WILSHIRE BLVD
Second Line	:	BUILDING 304, ROOM 3-113
City	:	LOS ANGELES
State	:	CA
Zip	:	90073-1003
Country	:	US
Telephone Number	:	310-478-3711
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2021
Last Update Date	:	04/29/2026

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