Individual provider Active NPI

Marc Constantino, DC

  • Chiropractor
  • Burbank, CA
National Provider Identifier
1104659358
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC36797 Issued in CA
Practice address
3607 W Magnolia Blvd Ste C
Burbank, CA 91505-2962
Phone
(747) 245-5421
Fax
(747) 245-6095
NPI assigned
Aug 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC36797 CA Primary

Addresses

Primary practice location

3607 W Magnolia Blvd Ste C
Burbank, CA 91505-2962

Mailing address

825 S Myrtle Ave Unit 427
Monrovia, CA 91016-8620
Phone (818) 321-2802

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

State licenses

LicenseStateTypeSpecialty
DC36797CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chapman Chiropractic Remedy Inc. Chiropractor CurrentSince Aug 25, 2024 Accepting new patients

Locations

3607 W Magnolia Blvd
Ste C
Burbank, CA 91505
Phone (747) 245-5421

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": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1104659358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 S MYRTLE AVE UNIT 427",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910168620",
            "telephone_number": "818-321-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3607 W MAGNOLIA BLVD STE C",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915052962",
            "telephone_number": "747-245-5421",
            "fax_number": "747-245-6095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSTANTINO",
        "first_name": "MARC",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC36797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.