Organization Active NPI

Kaivan-Mehr Chiropractic Inc

Doing business as Foothill Family Chiropractic

  • Chiropractor
  • La Verne, CA
National Provider Identifier
1043631088
Registry record updated Aug 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC30602 Issued in CA
Legal business name
KAIVAN-MEHR CHIROPRACTIC INC
Doing business as
Foothill Family Chiropractic
Practice address
2138 Bonita Ave
La Verne, CA 91750-4915
Phone
(909) 596-1038
Fax
(909) 596-6059
NPI assigned
Dec 18, 2013
Last updated
Aug 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2015

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

Authorized official

Name
Dr. Afshin Kaivan-Mehr, D.C.NPI 1205032653
Title
President
Phone
(626) 253-7139

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 DC30602 CA Primary

Addresses

Primary practice location

2138 Bonita Ave
La Verne, CA 91750-4915

Mailing address

2138 Bonita Ave
La Verne, CA 91750-4915
Phone (909) 596-1038

Other names 1

  • Foothill Family Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251201001260 CA Part B Supplier - Clinic/Group Practice 8022501980 Receives reassigned benefits from 1 practitioner
Practice locations: La Verne, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439164800000",
    "number": "1043631088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2138 BONITA AVE",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917504915",
            "telephone_number": "909-596-1038",
            "fax_number": "909-596-6059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2138 BONITA AVE",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917504915",
            "telephone_number": "909-596-1038",
            "fax_number": "909-596-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIVAN-MEHR CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-18",
        "last_updated": "2015-08-10",
        "status": "A",
        "authorized_official_last_name": "KAIVAN-MEHR",
        "authorized_official_first_name": "AFSHIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-253-7139",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC30602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foothill Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Verne, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; 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.