J Randall Miller Chiropractic Corporation

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

15316 Issued in CA

Legal business name

J RANDALL MILLER CHIROPRACTIC CORPORATION

Practice address

3151 Airway Ave.
Suite K103
Costa Mesa, CA 92626-3400

Phone

(714) 540-1710

Fax

(714) 540-3191

NPI assigned

Jan 22, 2009

Organization subpart

No

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

Authorized official

Name

Dr. J. Randall Miller, D.C.

Title

President

Phone

(714) 540-1710

Specialties & licenses 1

Addresses

Other names 1

• Miller Family Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Body Mechanics Walsh Chiropractic and Sports Therapy Corp

  • Chiropractor
  • Costa Mesa, CA
  • NPI 1689066904

  O20110113000916

  Same enrollment

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1053559419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 AIRWAY AVE.",
            "address_2": "SUITE K103",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263400",
            "telephone_number": "714-540-1710",
            "fax_number": "714-540-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 AIRWAY AVE.",
            "address_2": "SUITE K103",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263400",
            "telephone_number": "714-540-1710",
            "fax_number": "714-540-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J RANDALL MILLER CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-22",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "RANDALL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-540-1710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "15316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miller Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Suzanne Lee Itrich, OTR/L
• Alan Craig Ivar, DC
• Christian Ivie
• Cynthia Iwanicki, OTR
• Steven Izumi, MD
• Richard Jacildo
• Deanna Daniels Jacinto, LMFT
• Anna Jackobs
• Darcel Denise Jackson
• Jaelynn Dione Jackson

• Chiropractor in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.