Active NPI
Georgios A. Vagenas, D.C., Q.M.E.
- Chiropractor
- Pasadena, CA
National Provider Identifier
1093886764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC 28753
- Practice address
- 1060 E Green St Ste 109
Pasadena, CA 91106-2431 - Phone
- (626) 793-1255
- Fax
- (626) 793-1279
- NPI assigned
- Nov 13, 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 | DC 28753 | CA | Primary |
Addresses
Primary practice location
1060 E Green St Ste 109
Pasadena, CA 91106-2431
Mailing address
1060 E Green St Ste 109
Pasadena, CA 91106-2431
Phone (626) 793-1255
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 |
|---|---|---|---|
| DC 28753 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1093886764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1060 E GREEN ST STE 109",
"city": "PASADENA",
"state": "CA",
"postal_code": "911062431",
"telephone_number": "626-793-1255",
"fax_number": "626-793-1279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1060 E GREEN ST STE 109",
"city": "PASADENA",
"state": "CA",
"postal_code": "911062431",
"telephone_number": "626-793-1255",
"fax_number": "626-793-1279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAGENAS",
"first_name": "GEORGIOS",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "D.C., Q.M.E.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC 28753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.