Active NPI
Steven Michael Mamigonian, D.C.
- Chiropractor
- Fresno, CA
National Provider Identifier
1124186713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 21046
- Practice address
- 488 W Shaw Ave
Fresno, CA 93704-2511 - Phone
- (559) 227-0995
- Fax
- (559) 227-0904
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 21046 | CA | Primary |
Addresses
Primary practice location
488 W Shaw Ave
Fresno, CA 93704-2511
Mailing address
488 W Shaw Ave
Fresno, CA 93704-2511
Phone (559) 227-0995
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21046 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poladian Chiropractic Corporation | Chiropractor | Past | 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.
-
- Chiropractor
- Fresno, CA
- NPI 1275729824
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124186713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "488 W SHAW AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937042511",
"telephone_number": "559-227-0995",
"fax_number": "559-227-0904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "488 W SHAW AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937042511",
"telephone_number": "559-227-0995",
"fax_number": "559-227-0904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAMIGONIAN",
"first_name": "STEVEN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "21046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.