Individual provider Active NPI

Michael M. Mousavi, D.C., Q.M.E.

  • Chiropractor
  • Santa Ana, CA
National Provider Identifier
1063597623
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC24524 Issued in CA
Practice address
999 N Tustin Ave
Suite 101
Santa Ana, CA 92705-3528
Phone
(714) 543-5005
Fax
(714) 543-5595
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC24524 CA Primary

Addresses

Primary practice location

999 N Tustin Ave
Suite 101
Santa Ana, CA 92705-3528

Mailing address

999 N Tustin Ave
Suite 101
Santa Ana, CA 92705-3528
Phone (714) 543-5005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC24524CAMDChiropractor
24524CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
First Hope Medical Clinic Inc. CurrentSince Aug 26, 2009 Accepting new patients
FM Diagnostic Center Inc. PastSince Jan 3, 2007 Accepting new patients

Locations

999 N Tustin Ave
Ste 101
Santa Ana, CA 92705
Phone (714) 543-3345

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063597623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 N TUSTIN AVE",
            "address_2": "SUITE 101",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053528",
            "telephone_number": "714-543-5005",
            "fax_number": "714-543-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 N TUSTIN AVE",
            "address_2": "SUITE 101",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053528",
            "telephone_number": "714-543-5005",
            "fax_number": "714-543-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSAVI",
        "first_name": "MICHAEL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.C., Q.M.E.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC24524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.