Organization Active NPI

Gabriel Y. Edery, D.C. Chiropractic, Inc.

  • Chiropractor
  • Woodland Hills, CA
National Provider Identifier
1033570916
Registry record updated Oct 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC32583 Issued in CA
Legal business name
GABRIEL Y. EDERY, D.C. CHIROPRACTIC, INC.
Practice address
22311 Ventura Blvd Ste 116
Woodland Hills, CA 91364-1556
Phone
(818) 651-3252
Fax
(747) 242-1300
NPI assigned
Mar 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2024

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

Authorized official

Name
Gabriel Y Edery, D.CNPI 1265875199
Title
Owner
Phone
(818) 651-3252

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 DC32583 CA Primary

Addresses

Primary practice location

22311 Ventura Blvd Ste 116
Woodland Hills, CA 91364-1556

Mailing address

22311 Ventura Blvd Ste 116
Woodland Hills, CA 91364-1556
Phone (818) 651-3252

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161117001489 CA Part B Supplier - Clinic/Group Practice 7719266543 Receives reassigned benefits from 1 practitioner
Practice locations: Woodland Hills, CA

National Provider Directory

National Provider Directory

Locations

7439 Reseda Blvd
Reseda, CA 91335
Phone (818) 345-4924

22311 Ventura Blvd
Ste 116
Woodland Hills, CA 91364
Phone (818) 651-3252

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728172800000",
    "number": "1033570916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22311 VENTURA BLVD STE 116",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641556",
            "telephone_number": "818-651-3252",
            "fax_number": "747-242-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22311 VENTURA BLVD STE 116",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641556",
            "telephone_number": "818-651-3252",
            "fax_number": "747-242-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GABRIEL Y. EDERY, D.C. CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-18",
        "last_updated": "2024-10-06",
        "certification_date": "2024-10-06",
        "status": "A",
        "authorized_official_last_name": "EDERY",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-651-3252",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC32583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.