Individual provider Active NPI

Mayya Kravchenko, DC

  • Chiropractor
  • Los Angeles, CA
National Provider Identifier
1104096452
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
020567700 Issued in CA
Practice address
6221 Wilshire Blvd
604
Los Angeles, CA 90048-5201
Phone
(323) 933-2444
Fax
(323) 933-2909
NPI assigned
Mar 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 020567700 CA Primary

Addresses

Primary practice location

6221 Wilshire Blvd
604
Los Angeles, CA 90048-5201

Mailing address

6221 Wilshire Blvd
604
Los Angeles, CA 90048-5201
Phone (323) 933-2444

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eric E Gofnung Chiropractic Corporation Chiropractor PastSince Aug 15, 2021 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.

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1104096452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6221 WILSHIRE BLVD",
            "address_2": "604",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485201",
            "telephone_number": "323-933-2444",
            "fax_number": "323-933-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 WILSHIRE BLVD",
            "address_2": "604",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485201",
            "telephone_number": "323-933-2444",
            "fax_number": "323-933-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAVCHENKO",
        "first_name": "MAYYA",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "020567700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; 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.