Mission Lake Chiropractic Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC28966 Issued in CA

Legal business name

MISSION LAKE CHIROPRACTIC CENTER

Practice address

3600 Lime St Ste 210
Riverside, CA 92501-0900

Phone

(951) 683-6600

Fax

(951) 683-6644

NPI assigned

Aug 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ali Khamsei, D.C.

Title

Co-Owner/ Doctor

Phone

(951) 683-6600

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sharona Drake, D.C.

  • Chiropractor
  • Riverside, CA
  • NPI 1508970609
  NPD (past)
• Alex Kamsi, D.C.

  • Chiropractor
  • San Diego, CA
  • NPI 1851405955
  NPD (past)
• Azadeh Keshavarz, D.C.

  • Chiropractor
  • Riverside, CA
  • NPI 1194839191
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154435154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 LIME ST STE 210",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925010900",
            "telephone_number": "951-683-6600",
            "fax_number": "951-683-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 LIME ST STE 210",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925010900",
            "telephone_number": "951-683-6600",
            "fax_number": "951-683-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION LAKE CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KHAMSEI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "CO-OWNER/ DOCTOR",
        "authorized_official_telephone_number": "951-683-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC28966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mission Care Chiropractic
• Mission Dental Center
• Mission Grove Medical Corporation
• Mission Health Management Associates LLC
• Mission Inn Senior Living LLC
• Mission Medical Associates, Inc.
• Mission Medical Clinic
• Mission Surgical Center Inc
• Mission Surgical Clinic, Inc.
• Mission Surgical Group

• Chiropractor in Riverside, CA
• Providers in Riverside, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.