Organization Active NPI

Visico Chiropractic, Inc.

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1043797608
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
34262 Issued in CA
Legal business name
VISICO CHIROPRACTIC, INC.
Practice address
5850 Oberlin Dr Ste 220
San Diego, CA 92121-4711
Phone
(858) 453-0366
Fax
(858) 453-0370
NPI assigned
Jul 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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

Authorized official

Name
Dr. Christopher Visico, DCNPI 1346727906
Title
President
Phone
(858) 453-0366

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 34262 CA Primary

Addresses

Primary practice location

5850 Oberlin Dr Ste 220
San Diego, CA 92121-4711

Mailing address

5850 Oberlin Dr Ste 220
San Diego, CA 92121-4711
Phone (858) 453-0366

Other names 1

  • Mira Mesa Chiropractic Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190304002562 CA Part B Supplier - Clinic/Group Practice 6204175599 Receives reassigned benefits from 2 practitioners
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

5230 Carroll Canyon Rd
Ste 204
San Diego, CA 92121
Phone (858) 453-0366

5850 Oberlin Dr
Ste 220
San Diego, CA 92121
Phone (858) 453-0366

Practitioners & affiliated clinicians

Practitioners 3

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": "1532476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532476800000",
    "number": "1043797608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 OBERLIN DR STE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214711",
            "telephone_number": "858-453-0366",
            "fax_number": "858-453-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 OBERLIN DR STE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214711",
            "telephone_number": "858-453-0366",
            "fax_number": "858-453-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISICO CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-25",
        "last_updated": "2018-07-25",
        "status": "A",
        "authorized_official_last_name": "VISICO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-453-0366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "34262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mira Mesa Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mira Mesa Chiropractic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 25, 2018; 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.