Individual provider Active NPI

Monisha Mona Chanan, D.C.

  • Chiropractor
  • San Leandro, CA
National Provider Identifier
1043438039
Registry record updated Jun 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC26692 Issued in CA
Practice address
15200 Hesperian Blvd, Suite 104
San Leandro, CA 94578
Phone
(510) 468-0828
Fax
(510) 742-0784
NPI assigned
Apr 23, 2007
Last updated
Jun 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC26692 CA Primary
Radiology Chiropractor 111NR0200X DC26692 CA

Addresses

Primary practice location

15200 Hesperian Blvd, Suite 104
San Leandro, CA 94578

Mailing address

15200 Hesperian Blvd, Suite 104
San Leandro, CA 94578
Phone (510) 468-0828

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040701000564 CA Practitioner - Chiropractic 3072590637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1999
Medicare assignment
May accept Medicare assignment
Group practices
Coyle Chiropractic CorpGroup PAC ID 8426152695, 5 clinicians

Practice addresses (Care Compare)

6110 Hellyer Ave
Suite 100
San Jose, CA 95138-1061
Phone (370) 288-6453

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC26692CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Medical Center Inc Chiropractor Past Accepting new patients
Good Health Medical Center, Inc. Past Accepting new patients
Advanced DME LLC PastSince Apr 20, 2021 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307923200000",
    "number": "1043438039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15200 HESPERIAN BLVD, SUITE 104",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "94578",
            "telephone_number": "510-468-0828",
            "fax_number": "510-742-0784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15200 HESPERIAN BLVD, SUITE 104",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "94578",
            "telephone_number": "510-468-0828",
            "fax_number": "510-742-0784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANAN",
        "first_name": "MONISHA",
        "middle_name": "MONA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2011-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC26692",
            "primary": true
        },
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "CA",
            "license": "DC26692",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.