Organization Active NPI

First Chiropractic Family Wellness Center a Professional Corporation

  • Chiropractor
  • Montrose, CA
National Provider Identifier
1124238001
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
18540 Issued in CA
Legal business name
FIRST CHIROPRACTIC FAMILY WELLNESS CENTER A PROFESSIONAL CORPORATION
Practice address
2235 Honolulu Ave
Montrose, CA 91020-1635
Phone
(818) 249-2300
Fax
(818) 249-3204
NPI assigned
May 22, 2007
Last updated
Mar 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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

Authorized official

Name
Brian Patrick Miller, DCNPI 1417167396
Title
President
Phone
(818) 249-2300

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
Chiropractor 111N00000X 18540 CA Primary

Addresses

Primary practice location

2235 Honolulu Ave
Montrose, CA 91020-1635

Mailing address

2235 Honolulu Ave Ste a
Montrose, CA 91020-1635
Phone (818) 249-2300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220503000165 CA Part B Supplier - Clinic/Group Practice 3072900570 Receives reassigned benefits from 1 practitioner
Practice locations: Montrose, CA

National Provider Directory

National Provider Directory

Locations

2235 Honolulu Ave
Montrose, CA 91020
Phone (323) 459-6736

2235 Honolulu Ave
#A
Montrose, CA 91020
Phone (818) 249-2300

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647820800000",
    "number": "1124238001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 HONOLULU AVE STE A",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201635",
            "telephone_number": "818-249-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 HONOLULU AVE",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201635",
            "telephone_number": "818-249-2300",
            "fax_number": "818-249-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CHIROPRACTIC FAMILY WELLNESS CENTER A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-249-2300",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "18540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.