NPIMap

Organization Active NPI

Dr. Scott Nissenbaum Chiropractic LLC

  • Chiropractor
  • San Carlos, CA
National Provider Identifier
1104286368
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CA-31093 Issued in CA
Legal business name
DR. SCOTT NISSENBAUM CHIROPRACTIC LLC
Practice address
1100 Laurel St
Suite B
San Carlos, CA 94070-5000
Phone
(650) 226-8348
NPI assigned
Mar 2, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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

Authorized official

Name
Scott David Nissenbaum, D.C.NPI 1851694541
Title
Member
Phone
(650) 226-8348

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CA-31093 CA Primary

Addresses

Primary practice location

1100 Laurel St
Suite B
San Carlos, CA 94070-5000

Mailing address

1100 Laurel St
Suite B
San Carlos, CA 94070-5000
Phone (650) 226-8348

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456876800000",
    "number": "1104286368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 LAUREL ST",
            "address_2": "SUITE B",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940705000",
            "telephone_number": "650-226-8348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAUREL ST",
            "address_2": "SUITE B",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940705000",
            "telephone_number": "650-226-8348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. SCOTT NISSENBAUM CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-02",
        "last_updated": "2016-03-02",
        "status": "A",
        "authorized_official_last_name": "NISSENBAUM",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "650-226-8348",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "CA-31093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

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

Verify at the official NPI Registry.