Premiere Chiropractic and Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PREMIERE CHIROPRACTIC AND PHYSICAL THERAPY

Doing business as

Corona Chiropractic and Physical Therapy

Practice address

900 S Main St.
Unit 210
Corona, CA 92882

Phone

(714) 334-6211

NPI assigned

Oct 24, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Dong Hyun Gwag, DC

Title

Owner

Phone

(714) 334-6211

Specialties & licenses 3

Addresses

Other names 1

• Corona Chiropractic and Physical Therapy Doing business as

Locations

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

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1063233732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S MAIN ST.",
            "address_2": "UNIT 210",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "92882",
            "telephone_number": "714-334-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S MAIN ST.",
            "address_2": "UNIT 210",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "92882",
            "telephone_number": "714-334-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE CHIROPRACTIC AND PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "GWAG",
        "authorized_official_first_name": "DONG HYUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-334-6211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corona Chiropractic and Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapist in Corona, CA
• Providers in Corona, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.