Provider Demographics
NPI:1285801464
Name:DUNN, KEVIN (D C)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:DUNN
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 E DYER RD
Mailing Address - Street 2:SUITE 311
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5740
Mailing Address - Country:US
Mailing Address - Phone:949-863-0022
Mailing Address - Fax:
Practice Address - Street 1:29229 CANWOOD ST
Practice Address - Street 2:SUITE 205
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-1561
Practice Address - Country:US
Practice Address - Phone:310-649-5894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27047111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC27047OtherLICENSE