Individual provider Active NPI

Enrique Santana, DC

  • Chiropractor
  • San Pedro, CA
National Provider Identifier
1003197492
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
32082 Issued in CA
Practice address
28122 S Western Ave
San Pedro, CA 90732-1248
Phone
(310) 935-2470
Fax
(424) 536-3013
NPI assigned
Aug 30, 2011
Last updated
Apr 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 32082 CA Primary

Addresses

Primary practice location

28122 S Western Ave
San Pedro, CA 90732-1248

Mailing address

28122 S Western Ave
San Pedro, CA 90732-1248
Phone (310) 935-2470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190822000263 CA Practitioner - Chiropractic 9133483241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

28122 S Western Ave
San Pedro, CA 90732-1248
Phone (310) 935-2470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gutierrez Chiropractic Management Incorporated Chiropractor CurrentSince May 19, 2024 Accepting new patients
Maya Chiropractic Center Inc Chiropractor Past Accepting new patients

Locations

28122 S Western Ave
San Pedro, CA 90732
Phone (310) 935-2470

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1003197492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28122 S WESTERN AVE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907321248",
            "telephone_number": "310-935-2470",
            "fax_number": "424-536-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28122 S WESTERN AVE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907321248",
            "telephone_number": "310-935-2470",
            "fax_number": "424-536-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTANA",
        "first_name": "ENRIQUE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-30",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "32082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.