Costa Chiropractic Corporation

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC29364 Issued in CA

Legal business name

COSTA CHIROPRACTIC CORPORATION

Practice address

181 Avenida Vaquero
Ste D
San Clemente, CA 92672-3600

Phone

(949) 218-4750

Fax

(949) 276-7393

NPI assigned

Sep 30, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Cynthia Jayne Elizabeth Costa, D.C.NPI 1588680995

Title

Chiroprator/Owner

Phone

(949) 637-1668

Specialties & licenses 1

Addresses

Other names 1

• Costa Lifestlye Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cynthia J.E. Costa, D.C.

  • Chiropractor
  • Laguna Beach, CA
  • NPI 1588680995
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473206400000",
    "number": "1053748533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 AVENIDA VAQUERO",
            "address_2": "STE D",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723600",
            "telephone_number": "949-218-4750",
            "fax_number": "949-276-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 AVENIDA VAQUERO",
            "address_2": "STE D",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723600",
            "telephone_number": "949-218-4750",
            "fax_number": "949-276-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTA CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-30",
        "last_updated": "2016-09-07",
        "status": "A",
        "authorized_official_last_name": "COSTA",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "JAYNE ELIZABETH",
        "authorized_official_title_or_position": "CHIROPRATOR/OWNER",
        "authorized_official_telephone_number": "949-637-1668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC29364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Costa Lifestlye Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Contemporary Healthcare Medical Group, Inc.
• Christopher Reed Cook, R.D.H
• Coppola Chiropractic Inc.
• Michael Anthony Coppola Jr., D.C.
• Jay Cost, PT
• Counseling Solutions
• Regina Fridella Cousineau, RDN
• Tracie Louise Covey Borchard, LMFT
• Tim David Cowell, P.T.
• Maria Coy

• Chiropractor in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.