Organization Active NPI

Bahbah Chiropractic Corporation

  • Chiropractor
  • Glendora, CA
National Provider Identifier
1003635301
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BAHBAH CHIROPRACTIC CORPORATION
Practice address
210 S Grand Ave Ste 109
Glendora, CA 91741-4260
Phone
(602) 751-4220
NPI assigned
Oct 4, 2024
Last updated
Dec 11, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BAHBAH CHIROPRACTIC CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Authorized official

Name
Jacob J Bahbah, DCNPI 1215798905
Title
President/Chiropractor
Phone
(602) 751-4220

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

210 S Grand Ave Ste 109
Glendora, CA 91741-4260

Mailing address

2207 Swiftwater Way
Glendora, CA 91741-4606
Phone (602) 751-4220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241224001144 CA Part B Supplier - Clinic/Group Practice 6608303086 Receives reassigned benefits from 1 practitioner
Practice locations: Glendora, CA

National Provider Directory

National Provider Directory
Part of
Bahbah Chiropractic Corporation

Locations

210 S Grand Ave
Ste 109
Glendora, CA 91741
Phone (602) 751-4220

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1728000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1003635301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2207 SWIFTWATER WAY",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414606",
            "telephone_number": "602-751-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S GRAND AVE STE 109",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414260",
            "telephone_number": "602-751-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAHBAH CHIROPRACTIC CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAHBAH CHIROPRACTIC CORPORATION",
        "enumeration_date": "2024-10-04",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "BAHBAH",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/CHIROPRACTOR",
        "authorized_official_telephone_number": "602-751-4220",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.