NPIMap

Organization Active NPI

Disiena Family Chiropractic, a Prof Corp

  • Chiropractor
  • Irvine, CA
National Provider Identifier
1043496441
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC17101 Issued in CA
Legal business name
DISIENA FAMILY CHIROPRACTIC, A PROF CORP
Practice address
6 Venture
Suite 115
Irvine, CA 92618-8853
Phone
(949) 559-6030
Fax
(949) 559-6037
NPI assigned
Jan 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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

Authorized official

Name
Douglas A Disiena, DC, FICA, QMENPI 1356417943
Title
President
Phone
(949) 559-6030

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X DC17101 CA Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X DC17166 CA
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X DC25546 CA
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X DC26991 CA
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X DC25305 CA

Addresses

Primary practice location

6 Venture
Suite 115
Irvine, CA 92618-8853

Mailing address

6 Venture
Suite 115
Irvine, CA 92618-3340
Phone (949) 559-6030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081222000100 CA Part B Supplier - Clinic/Group Practice 0143382465 Receives reassigned benefits from 3 practitioners
Practice locations: Irvine, CA

National Provider Directory

National Provider Directory

Locations

4482 Barranca Pkwy
Ste 170
Irvine, CA 92604
Phone (949) 559-6030

6 Venture
Ste 115
Irvine, CA 92618
Phone (949) 551-8002

Practitioners & affiliated clinicians

Practitioners 5

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": "1200355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1043496441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 VENTURE",
            "address_2": "SUITE 115",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183340",
            "telephone_number": "949-559-6030",
            "fax_number": "949-559-6037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 VENTURE",
            "address_2": "SUITE 115",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926188853",
            "telephone_number": "949-559-6030",
            "fax_number": "949-559-6037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISIENA FAMILY CHIROPRACTIC, A PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-15",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "DISIENA",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-559-6030",
        "authorized_official_credential": "DC, FICA, QME"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC17101",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC17166",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC25546",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC26991",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC25305",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.