Provider Demographics
NPI:1124164033
Name:CAKE, CHRIS (DC)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:
Last Name:CAKE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 STANDIFORD AVE # 2
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-6529
Mailing Address - Country:US
Mailing Address - Phone:209-622-1760
Mailing Address - Fax:209-578-3539
Practice Address - Street 1:2020 STANDIFORD AVE # 2
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-6529
Practice Address - Country:US
Practice Address - Phone:209-622-1760
Practice Address - Fax:209-578-3539
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28302111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor