San Diego Spine and Wellness Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC23346 Issued in CA

Legal business name

SAN DIEGO SPINE AND WELLNESS CENTER

Practice address

16445 Bernardo Center Dr
San Diego, CA 92128-2523

Phone

(858) 676-1166

Fax

(858) 676-1172

NPI assigned

Feb 6, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Linda Marie Siclare, CCA

Title

Office Manager

Phone

(858) 676-1171

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• San Diego Spine and Wellness Center Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Lawrence Padilla, D.C.

  • Chiropractor
  • San Diego, CA
  • NPI 1932206083
  Medicare reassignment NPD
• Stephen M Daquino, DO

  • Sports Medicine (Family Medicine) Physician
  • San Diego, CA
  • NPI 1346351665
  NPD

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456358400000",
    "number": "1003955733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16445 BERNARDO CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282523",
            "telephone_number": "858-676-1166",
            "fax_number": "858-676-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16445 BERNARDO CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282523",
            "telephone_number": "858-676-1166",
            "fax_number": "858-676-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO SPINE AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2016-02-25",
        "status": "A",
        "authorized_official_last_name": "SICLARE",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "858-676-1171",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CCA"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC23346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1932206083",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1003955733",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Diego Spine and Wellness Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• San Diego Speech Pathology Services Inc.
• San Diego Spinal Care
• San Diego Spine Center
• San Diego Spine Center, AMC
• San Diego Sports Acupuncture, Inc
• San Diego Sports and Minimally Invasive Surgery Center LLC
• San Diego Sports Medicine & Orthopaedic Center

• 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 Feb 25, 2016; 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.