NPIMap

Organization Active NPI

Optimal Spine & Health Medical Center, Inc.

  • General Practice Physician
  • West Covina, CA
National Provider Identifier
1073749495
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
C51512 Issued in CA
Legal business name
OPTIMAL SPINE & HEALTH MEDICAL CENTER, INC.
Practice address
2361 S Azusa Ave
West Covina, CA 91792-1537
Phone
(626) 965-2334
Fax
(626) 964-6504
NPI assigned
Jun 1, 2009
Last updated
Jan 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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

Authorized official

Name
Dr. Andrew Joseph Keith, D.C.NPI 1003909409
Title
President
Phone
(626) 965-2334

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X DC15972 CA
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X C51512 CA Primary

Addresses

Primary practice location

2361 S Azusa Ave
West Covina, CA 91792-1537

Mailing address

2361 S Azusa Ave
West Covina, CA 91792-1537
Phone (626) 965-2334

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326067200000",
    "number": "1073749495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2361 S AZUSA AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917921537",
            "telephone_number": "626-965-2334",
            "fax_number": "626-964-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2361 S AZUSA AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917921537",
            "telephone_number": "626-965-2334",
            "fax_number": "626-964-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL SPINE & HEALTH MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-01",
        "last_updated": "2012-01-09",
        "status": "A",
        "authorized_official_last_name": "KEITH",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-965-2334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC15972",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "C51512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2012; 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.