Organization Active NPI

Joshua Deitch Chiropractic, Inc

  • Rehabilitation Chiropractor
  • Mill Valley, CA
National Provider Identifier
1063534170
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
DC 27039 Issued in CA
Legal business name
JOSHUA DEITCH CHIROPRACTIC, INC
Practice address
465 Miller Ave
Mill Valley, CA 94941-2941
Phone
(415) 389-1098
Fax
(415) 389-1097
NPI assigned
Apr 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Joshua Ari Deitch, D.C.
Title
Owner
Phone
(415) 389-1098

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X DC 27039 CA Primary

Addresses

Primary practice location

465 Miller Ave
Mill Valley, CA 94941-2941

Mailing address

465 Miller Ave
Mill Valley, CA 94941-2941
Phone (415) 389-1098

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040319001448 CA Part B Supplier - Clinic/Group Practice 0345130431 Receives reassigned benefits from 1 practitioner
Practice locations: Mill Valley, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063534170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 MILLER AVE",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412941",
            "telephone_number": "415-389-1098",
            "fax_number": "415-389-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 MILLER AVE",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412941",
            "telephone_number": "415-389-1098",
            "fax_number": "415-389-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSHUA DEITCH CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEITCH",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "ARI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-389-1098",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CA",
            "license": "DC 27039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.