Provider Demographics
NPI:1861716979
Name:CACHO, JESSTOFED MANUEL (DC)
Entity type:Individual
Prefix:DR
First Name:JESSTOFED
Middle Name:MANUEL
Last Name:CACHO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:J.C.
Other - Middle Name:MANUEL
Other - Last Name:CACHO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:21602 FIGUEROA ST
Mailing Address - Street 2:UNIT 21
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-1969
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21602 FIGUEROA ST
Practice Address - Street 2:UNIT 21
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-1969
Practice Address - Country:US
Practice Address - Phone:310-634-2322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31588111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor