Organization Active NPI

Non Surgical Spine Center

  • Specialist
  • Fountain Valley, CA
National Provider Identifier
1013140110
Registry record updated Dec 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C31371 Issued in CA
Legal business name
NON SURGICAL SPINE CENTER
Practice address
18055 Bushard St
Fountain Valley, CA 92708-5760
Phone
(714) 546-3472
NPI assigned
Aug 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2009

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

Authorized official

Name
Dr. Robert S Young, M.D.
Title
Share Holder
Phone
(760) 546-3472

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X C31371 CA Primary

Addresses

Primary practice location

18055 Bushard St
Fountain Valley, CA 92708-5760

Mailing address

18055 Bushard St
Fountain Valley, CA 92708-5760
Phone (714) 546-3472

National Provider Directory

National Provider Directory

Locations

18055 Bushard St
Fountain Vly, CA 92708
Phone (714) 964-4444

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": "1251072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261526400000",
    "number": "1013140110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18055 BUSHARD ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085760",
            "telephone_number": "714-546-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18055 BUSHARD ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085760",
            "telephone_number": "714-546-3472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NON SURGICAL SPINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-24",
        "last_updated": "2009-12-23",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SHARE HOLDER",
        "authorized_official_telephone_number": "760-546-3472",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "C31371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; 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.