Costantino Chiropractic Corporation

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

21279 Issued in CA

Legal business name

COSTANTINO CHIROPRACTIC CORPORATION

Doing business as

Health Source Chiropractic

Practice address

1100 Pacific Coast Hwy
Suite a
Hermosa Beach, CA 90254-3951

Phone

(310) 798-3227

Fax

(310) 798-3229

NPI assigned

May 2, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Matthew David Costantino, D.C.NPI 1447463096

Title

Owner/Ceo

Phone

(310) 798-3227

Specialties & licenses 1

Addresses

Other names 1

• Health Source Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew David Costantino, D.C.

  • Rehabilitation Chiropractor
  • Hermosa Beach, CA
  • NPI 1447463096
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335916800000",
    "number": "1073871547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 PACIFIC COAST HWY",
            "address_2": "SUITE A",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902543951",
            "telephone_number": "310-798-3227",
            "fax_number": "310-798-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 PACIFIC COAST HWY",
            "address_2": "SUITE A",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902543951",
            "telephone_number": "310-798-3227",
            "fax_number": "310-798-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTANTINO CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-02",
        "last_updated": "2012-05-02",
        "status": "A",
        "authorized_official_last_name": "COSTANTINO",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "310-798-3227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "21279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Source Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Grant Alexander Contreras
• Erika Kathryn Cooley, OTR/L
• Irwin Cooper, M.D.
• Tristan Coopersmith, MFT
• Salvatore Cosentino
• Costantino Chiropractic Corporation
• Matthew David Costantino, D.C.
• Sharon Coulter, MFT
• Courtney Hamlin Counseling, Inc.
• Elizabeth Ellen Cowart, MD

• Chiropractor in Hermosa Beach, CA
• Providers in Hermosa Beach, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; 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.