Dr. Scott South Corona Chiropractic Center Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC26137 Issued in CA

Legal business name

DR. SCOTT SOUTH CORONA CHIROPRACTIC CENTER INC.

Doing business as

Active Life Chiropractic Pain Relief and Wellness Center

Practice address

4260 Central Ave
Riverside, CA 92506-2937

Phone

(951) 686-5040

Fax

(951) 686-5049

NPI assigned

Apr 11, 2007

Last updated

Feb 26, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert Jeffery Scott, D.C.NPI 1518986173

Title

Owner, Clinician

Phone

(951) 686-5040

Specialties & licenses 1

Addresses

Other names 1

• Active Life Chiropractic Pain Relief and Wellness Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Jeffery Scott, D.C.

  • Chiropractor
  • Riverside, CA
  • NPI 1518986173
  NPD (past) Authorized official

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267142400000",
    "number": "1063636371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4260 CENTRAL AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062937",
            "telephone_number": "951-686-5040",
            "fax_number": "951-686-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4260 CENTRAL AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062937",
            "telephone_number": "951-686-5040",
            "fax_number": "951-686-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. SCOTT SOUTH CORONA CHIROPRACTIC CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2010-02-26",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JEFFERY",
        "authorized_official_title_or_position": "OWNER, CLINICIAN",
        "authorized_official_telephone_number": "951-686-5040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC26137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Life Chiropractic Pain Relief and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Riverside, CA
• Providers in Riverside, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2010; 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.