Provider Demographics
NPI:1730256520
Name:FRANK, KENNETH ARTHUR (DC)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:ARTHUR
Last Name:FRANK
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 1:730 SPAANS DR
Mailing Address - Street 2:B
Mailing Address - City:GALT
Mailing Address - State:CA
Mailing Address - Zip Code:95632-8607
Mailing Address - Country:US
Mailing Address - Phone:209-744-4366
Mailing Address - Fax:209-744-1710
Practice Address - Street 1:730 SPAANS DR
Practice Address - Street 2:B
Practice Address - City:GALT
Practice Address - State:CA
Practice Address - Zip Code:95632-8607
Practice Address - Country:US
Practice Address - Phone:209-744-4366
Practice Address - Fax:209-744-1710
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 28230111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC 0282301Medicare PIN
U91826Medicare UPIN