Revilla Chiropractic a Professional Corporation

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC 20363 Issued in CA

Legal business name

REVILLA CHIROPRACTIC A PROFESSIONAL CORPORATION

Practice address

555 S Rancho Santa Fe Rd
Suite 200
San Marcos, CA 92078-3698

Phone

(760) 736-0286

Fax

(760) 736-3113

NPI assigned

Jan 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Russell Steven Revilla, D.C.

Title

President

Phone

(760) 736-0286

Specialties & licenses 1

Addresses

Other names 1

• Comprehensive Health and Chiropractic Doing business as

Locations

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591747200000",
    "number": "1164572566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S RANCHO SANTA FE RD",
            "address_2": "SUITE 200",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920783698",
            "telephone_number": "760-736-0286",
            "fax_number": "760-736-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S RANCHO SANTA FE RD",
            "address_2": "SUITE 200",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920783698",
            "telephone_number": "760-736-0286",
            "fax_number": "760-736-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVILLA CHIROPRACTIC A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A",
        "authorized_official_last_name": "REVILLA",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-736-0286",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 20363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comprehensive Health and Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Comprehensive Health and Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Reppas & El-Maasri Dental Inc.
• Constantine Nicolas Reppas, D.M.D
• Mireya Resendez
• Brene Breanna Resendiz Baltazar
• Christina Resendiz
• Russell S Revilla, D.C.
• Jaidee Mae Reyes, OTR/L
• Nancy Inge Reyes, CPSS, RAOD
• Ruby Reyes
• Veronica Reyes, MD

• Chiropractor in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.