Individual provider Active NPI

Corey Diamond, DC34416

  • Chiropractor
  • San Clemente, CA
National Provider Identifier
1174089932
Registry record updated Feb 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC34416 Issued in CA
Practice address
629 Camino de Los Mares Ste 104
San Clemente, CA 92673-2829
Phone
(949) 240-1334
Fax
(949) 240-4434
NPI assigned
Feb 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC34416 CA Primary

Addresses

Primary practice location

629 Camino de Los Mares Ste 104
San Clemente, CA 92673-2829

Mailing address

629 Camino de Los Mares Ste 104
San Clemente, CA 92673-2829
Phone (949) 240-1334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DC34416CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
David Ahrens Chiropractor Past Accepting new patients
Russell Thompson Chiropractic Inc PastSince Jul 1, 2017 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1550448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1174089932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 CAMINO DE LOS MARES STE 104",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732829",
            "telephone_number": "949-240-1334",
            "fax_number": "949-240-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 CAMINO DE LOS MARES STE 104",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732829",
            "telephone_number": "949-240-1334",
            "fax_number": "949-240-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAMOND",
        "first_name": "COREY",
        "credential": "DC34416",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-18",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC34416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; 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.