Kaiden Maxwell, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC26801 Issued in CA

Practice address

128 E Cliff St
Solana Beach, CA 92075-1259

Phone

(760) 846-1063

NPI assigned

Feb 22, 2007

Last updated

Jan 23, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• David Revivo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1881729689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 E CLIFF ST",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920751259",
            "telephone_number": "760-846-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 E CLIFF ST",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920751259",
            "telephone_number": "760-846-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "KAIDEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC26801",
            "primary": true
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CA",
            "license": "DC26801",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "REVIVO",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Thomas A. Markle II, D. M. D.
• Anellina Marrelli, L.C.S.W.
• Nicholas Martin
• Benedicto Gaona Masilungan, MD
• Claudia Matar de Brun, AMFT
• Lana Jessica Maxwell, PSY.D.
• Charles Francis Mayberry, L.AC.
• Tami Mayers, PHARM.D.
• Rosalily Mayorquin
• Mary M. Mazaheri, PH.D.

• Chiropractor in Solana Beach, CA
• Providers in Solana Beach, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.