Organization Active NPI

Guadamuz Chiropractic Inc.

  • Chiropractor
  • San Jacinto, CA
National Provider Identifier
1154648533
Registry record updated May 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
27604 Issued in CA
Legal business name
GUADAMUZ CHIROPRACTIC INC.
Practice address
1695 S San Jacinto Ave
Ste. O
San Jacinto, CA 92583-5103
Phone
(951) 654-5900
Fax
(951) 654-5933
NPI assigned
Apr 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2010

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

Authorized official

Name
Dr. Roberto Jose Guadamuz, D.C.NPI 1457677189
Title
Chiropractor
Phone
(951) 533-2214

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 27604 CA Primary

Addresses

Primary practice location

1695 S San Jacinto Ave
Ste. O
San Jacinto, CA 92583-5103

Mailing address

1695 S San Jacinto Ave
Ste. O
San Jacinto, CA 92583-5103
Phone (951) 654-5900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101011000965 CA Part B Supplier - Clinic/Group Practice 8820280738 Receives reassigned benefits from 1 practitioner
Practice locations: San Jacinto, CA

National Provider Directory

National Provider Directory

Locations

1695 S San Jacinto Ave
Ste O
San Jacinto, CA 92583
Phone (951) 654-5900

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273708800000",
    "number": "1154648533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 S SAN JACINTO AVE",
            "address_2": "STE. O",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925835103",
            "telephone_number": "951-654-5900",
            "fax_number": "951-654-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 S SAN JACINTO AVE",
            "address_2": "STE. O",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925835103",
            "telephone_number": "951-654-5900",
            "fax_number": "951-654-5933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUADAMUZ CHIROPRACTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-26",
        "last_updated": "2010-05-13",
        "status": "A",
        "authorized_official_last_name": "GUADAMUZ",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_middle_name": "JOSE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "951-533-2214",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "27604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jacinto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2010; 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.