Sulakshandan Kathireson, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

34704 Issued in CA

Practice address

1040 University Ave # B210
San Diego, CA 92103-7328

Phone

(619) 230-5420

NPI assigned

Sep 19, 2019

Last updated

Mar 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Shane Kathireson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1780234872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12901 SE KENT KANGLEY RD",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307939",
            "telephone_number": "253-630-1575",
            "fax_number": "253-630-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 UNIVERSITY AVE # B210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921037328",
            "telephone_number": "619-230-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATHIRESON",
        "first_name": "SULAKSHANDAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-19",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60981294",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "34704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANE",
            "last_name": "KATHIRESON",
            "credential": "DC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Kathryn Johnson
• David Jonathan Katibian, MD

• Chiropractor in San Diego, CA
• Providers in San Diego, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.