Provider Demographics
NPI:1124527577
Name:MCCLOSKEY, KARLEY KING (DC)
Entity type:Individual
Prefix:DR
First Name:KARLEY
Middle Name:KING
Last Name:MCCLOSKEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1253 FLORENCE ST
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:91932-3606
Mailing Address - Country:US
Mailing Address - Phone:337-277-0130
Mailing Address - Fax:
Practice Address - Street 1:1340 IMPERIAL BEACH BLVD STE 100A
Practice Address - Street 2:
Practice Address - City:IMPERIAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:91932-3046
Practice Address - Country:US
Practice Address - Phone:337-277-0130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34945111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA34945OtherCHIROPRACTIC