Active NPI
Michael Erdman, D.C.
- Chiropractor
- Manteca, CA
National Provider Identifier
1083701494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC27054
- Practice address
- 1126 N Main St
Manteca, CA 95336-3208 - Phone
- (209) 824-8090
- Fax
- (209) 824-5468
- NPI assigned
- Oct 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC27054 | CA | Primary |
Addresses
Primary practice location
1126 N Main St
Manteca, CA 95336-3208
Mailing address
95 Argonaut
280
Aliso Viejo, CA 92656-4133
Phone (949) 598-9999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC0270540 | Other | CA | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090126000122 | CA | Practitioner - Chiropractic | 0143384867 | Practice locations: Manteca, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC27054 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083701494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 ARGONAUT",
"address_2": "280",
"city": "ALISO VIEJO",
"state": "CA",
"postal_code": "926564133",
"telephone_number": "949-598-9999",
"fax_number": "949-598-9990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1126 N MAIN ST",
"city": "MANTECA",
"state": "CA",
"postal_code": "953363208",
"telephone_number": "209-824-8090",
"fax_number": "209-824-5468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERDMAN",
"first_name": "MICHAEL",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC27054",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "DC0270540",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manteca, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.