Provider Demographics
NPI:1124171707
Name:TILTMANN, KAI K (DC)
Entity type:Individual
Prefix:DR
First Name:KAI
Middle Name:K
Last Name:TILTMANN
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 1:555 FRONT STREET
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111
Mailing Address - Country:US
Mailing Address - Phone:415-781-2225
Mailing Address - Fax:415-781-4115
Practice Address - Street 1:555 FRONT STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111
Practice Address - Country:US
Practice Address - Phone:415-781-2225
Practice Address - Fax:415-781-4115
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 26156111NR0400X, 111NS0005X, 111NX0100X
CADC26156111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NX0100XChiropractic ProvidersChiropractorOccupational Health