Coppola Chiropractic Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

DC 30393 Issued in CA

Legal business name

COPPOLA CHIROPRACTIC INC.

Doing business as

Active Life Healthcare

Practice address

380 Camino de Estrella
San Clemente, CA 92672-4859

Phone

(949) 487-1231

NPI assigned

Jan 3, 2009

Last updated

Mar 1, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Anthony Coppola Jr., D.C.NPI 1699962423

Title

President

Phone

(949) 487-1231

Specialties & licenses 1

Addresses

Other names 1

• Active Life Healthcare Doing business as

Locations

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.

• Michael Anthony Coppola Jr., D.C.

  • Chiropractor
  • San Clemente, CA
  • NPI 1699962423
  Authorized official Same address or phone

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

{
    "created_epoch": "1230940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1023254653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 CAMINO DE ESTRELLA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724859",
            "telephone_number": "949-487-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 CAMINO DE ESTRELLA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724859",
            "telephone_number": "949-487-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPOLA CHIROPRACTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-03",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "COPPOLA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-487-1231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "DC 30393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Life Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Comprenhensive Vocational Services
• Cassandra Eve Conlin, OTR/L
• Alyssa Carolyn Conrad
• Contemporary Healthcare Medical Group, Inc. (CHMG)
• Christopher Reed Cook, R.D.H
• Michael Anthony Coppola Jr., D.C.
• Jay Cost, PT
• Costa Chiropractic Corporation (Costa Lifestlye Medicine)
• Counseling Solutions
• Regina Fridella Cousineau, RDN

• Clinic/Center in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; 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.