Individual provider Active NPI

Gary De Forest, D.C.

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1033238365
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
D.C. 16331 Issued in CA
Practice address
2304 San Diego Ave Ste C
San Diego, CA 92110-2896
Phone
(619) 291-2462
Fax
(619) 291-9242
NPI assigned
Mar 28, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X D.C. 16331 CA Primary

Addresses

Primary practice location

2304 San Diego Ave Ste C
San Diego, CA 92110-2896

Mailing address

2304 San Diego Ave Ste C
San Diego, CA 92110-2896
Phone (619) 291-2462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D.C. 16331CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033238365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 SAN DIEGO AVE STE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102896",
            "telephone_number": "619-291-2462",
            "fax_number": "619-291-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 SAN DIEGO AVE STE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102896",
            "telephone_number": "619-291-2462",
            "fax_number": "619-291-9242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE FOREST",
        "first_name": "GARY",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "D.C. 16331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.