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Organization
KINSELLA CHIROPRACTIC INC
Active
Organization
KINSELLA CHIROPRACTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRIS GERARD KINSELLA D.C (OWNER)
(858) 581-1828
Entity
Organization
Contact information
Practice address
4501 MISSION BAY DR STE 2D, SAN DIEGO, CA 92109-4925
(858) 581-1828
Mailing address
4501 MISSION BAY DR STE 2D, SAN DIEGO, CA 92109-4925
(858) 581-1828
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC28570
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4275636
—
CA
01
—
W18822
MEDICARE GROUP ID
CA
01
—
WDC28570A
MEDICARE MEMBER ID
CA
Enumeration date
08/15/2007
Last updated
08/05/2008
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