NPIMap

Organization Active NPI

Russo Chiropractic Corp.

  • Independent Medical Examiner Chiropractor
  • Garden Grove, CA
National Provider Identifier
1164623864
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Medical Examiner ChiropractorTaxonomy code 111NI0013X
License
22452 Issued in CA
Legal business name
RUSSO CHIROPRACTIC CORP.
Practice address
12362 Euclid St
Garden Grove, CA 92840-3308
Phone
(714) 534-5712
Fax
(714) 882-7371
NPI assigned
May 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Micheal Russo, D.C. QME
Title
President
Phone
(714) 534-5712

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Medical Examiner ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NI0013X 22452 CA Primary

Addresses

Primary practice location

12362 Euclid St
Garden Grove, CA 92840-3308

Mailing address

12362 Euclid St
Garden Grove, CA 92840-3308
Phone (714) 534-5712

National Provider Directory

National Provider Directory

Locations

12362 Euclid St
Garden Grove, CA 92840
Phone (714) 534-5712

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": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164623864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12362 EUCLID ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928403308",
            "telephone_number": "714-534-5712",
            "fax_number": "714-882-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12362 EUCLID ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928403308",
            "telephone_number": "714-534-5712",
            "fax_number": "714-882-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSO CHIROPRACTIC CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "MICHEAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-534-5712",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C. QME"
    },
    "taxonomies": [
        {
            "code": "111NI0013X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "CA",
            "license": "22452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • 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.