Organization Active NPI

Gottlieb Chiropractic and Health Services Inc

  • Chiropractor
  • Fair Oaks, CA
National Provider Identifier
1164453189
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
20608 Issued in CA
Legal business name
GOTTLIEB CHIROPRACTIC AND HEALTH SERVICES INC
Practice address
4401 Hazel Ave Ste 100
Fair Oaks, CA 95628-6695
Phone
(916) 965-7155
Fax
(916) 966-6085
NPI assigned
Jul 6, 2006
Last updated
Oct 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Dr. Brett Alan Gottlieb, D.C.NPI 1497864391
Title
Owner
Phone
(916) 965-7155

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 20608 CA Primary

Addresses

Primary practice location

4401 Hazel Ave Ste 100
Fair Oaks, CA 95628-6695

Mailing address

4401 Hazel Ave Ste 100
Fair Oaks, CA 95628-6695
Phone (916) 965-7155

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060801000205 CA Part B Supplier - Clinic/Group Practice 7416960851 Receives reassigned benefits from 1 practitioner
Practice locations: Fair Oaks, CA

National Provider Directory

National Provider Directory

Locations

4401 Hazel Ave
Ste 100
Fair Oaks, CA 95628
Phone (916) 962-2225

4818 San Juan Ave
Fair Oaks, CA 95628

Practitioners & affiliated clinicians

Practitioners 1

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": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1164453189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 HAZEL AVE STE 100",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956286695",
            "telephone_number": "916-965-7155",
            "fax_number": "916-965-4531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 HAZEL AVE STE 100",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956286695",
            "telephone_number": "916-965-7155",
            "fax_number": "916-966-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOTTLIEB CHIROPRACTIC AND HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-15",
        "status": "A",
        "authorized_official_last_name": "GOTTLIEB",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-965-7155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "20608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.