Active NPI
Vincent Joseph Surace Sr., D.C.
- Chiropractor
- San Pedro, CA
National Provider Identifier
1083797013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 01-10283
- Practice address
- 928 N Western Ave
San Pedro, CA 90732-2427 - Phone
- (310) 850-0989
- Fax
- (714) 547-5694
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 01-10283 | CA | Primary |
Addresses
Primary practice location
928 N Western Ave
San Pedro, CA 90732-2427
Mailing address
28134 S Western Ave # 196
San Pedro, CA 90732-1248
Phone (310) 893-9954
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
| License | State | Type | Specialty |
|---|---|---|---|
| 01-10283 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surace'S Chiropractic Back Alert Clinic | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Santa Ana, CA
- NPI 1598097446
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480636800000",
"number": "1083797013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28134 S WESTERN AVE # 196",
"city": "SAN PEDRO",
"state": "CA",
"postal_code": "907321248",
"telephone_number": "310-893-9954",
"fax_number": "714-547-5694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "928 N WESTERN AVE",
"city": "SAN PEDRO",
"state": "CA",
"postal_code": "907322427",
"telephone_number": "310-850-0989",
"fax_number": "714-547-5694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SURACE",
"first_name": "VINCENT",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2016-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "01-10283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Pedro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.