Provider Demographics
NPI:1548702673
Name:KASHI, KAYKAVOOS (DC)
Entity type:Individual
Prefix:
First Name:KAYKAVOOS
Middle Name:
Last Name:KASHI
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 1:5404 SPRUCE TREE AVE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-1600
Mailing Address - Country:US
Mailing Address - Phone:571-643-1000
Mailing Address - Fax:
Practice Address - Street 1:2001 EASTERN AVE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231-3061
Practice Address - Country:US
Practice Address - Phone:443-842-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03876111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor