Organization Active NPI

Prunedale Chiropractic

  • Chiropractor
  • Prunedale, CA
National Provider Identifier
1114120433
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC23062 Issued in CA
Legal business name
PRUNEDALE CHIROPRACTIC
Practice address
17802 Moro Rd
Prunedale, CA 93907-8962
Phone
(831) 663-6330
Fax
(831) 663-6332
NPI assigned
Jun 6, 2007
Last updated
Apr 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Authorized official

Name
Dr. Jonathan C. Milrod, D.C.
Title
Owner
Phone
(831) 663-6330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC23062 CA Primary

Addresses

Primary practice location

17802 Moro Rd
Prunedale, CA 93907-8962

Mailing address

17802 Moro Rd
Prunedale, CA 93907-8962
Phone (831) 663-6330

National Provider Directory

National Provider Directory
Tax ID family
Advantage Care Health Croup2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

17802 Moro Rd
Prunedale, CA 93907
Phone (831) 663-6330

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492041600000",
    "number": "1114120433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17802 MORO RD",
            "city": "PRUNEDALE",
            "state": "CA",
            "postal_code": "939078962",
            "telephone_number": "831-663-6330",
            "fax_number": "831-663-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17802 MORO RD",
            "city": "PRUNEDALE",
            "state": "CA",
            "postal_code": "939078962",
            "telephone_number": "831-663-6330",
            "fax_number": "831-663-6332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUNEDALE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2017-04-13",
        "status": "A",
        "authorized_official_last_name": "MILROD",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "831-663-6330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC23062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prunedale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.