Individual provider Active NPI

Jorge Paul Santana, D.C.

  • Chiropractor
  • Brea, CA
National Provider Identifier
1124178504
Registry record updated Nov 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
17593 Issued in CA
Practice address
400 W Lambert Rd
Suite A2
Brea, CA 92821-3936
Phone
(714) 529-3422
Fax
(714) 529-3357
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 17593 CA Primary
Sports Physician Chiropractor 111NS0005X 17593 CA

Addresses

Primary practice location

400 W Lambert Rd
Suite A2
Brea, CA 92821-3936

Mailing address

400 W Lambert Rd
Suite A2
Brea, CA 92821-3936
Phone (714) 529-3422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080812000889 CA Practitioner - Chiropractic 5799850657 Practice locations: Brea, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

400 W Lambert Rd
A2
Brea, CA 92821-3936
Phone (714) 529-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17593CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195516800000",
    "number": "1124178504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W LAMBERT RD",
            "address_2": "SUITE A2",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213936",
            "telephone_number": "714-529-3422",
            "fax_number": "714-529-3357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W LAMBERT RD",
            "address_2": "SUITE A2",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213936",
            "telephone_number": "714-529-3422",
            "fax_number": "714-529-3357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTANA",
        "first_name": "JORGE",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "17593",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "17593",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.