Organization Active NPI

North Glen Chiropractic, a Professional Corporation

  • Chiropractor
  • Los Angeles, CA
National Provider Identifier
1174503072
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
20329 Issued in CA
Legal business name
NORTH GLEN CHIROPRACTIC, A PROFESSIONAL CORPORATION
Practice address
3542 Hollydale Dr
Los Angeles, CA 90039-2117
Phone
(818) 247-4766
NPI assigned
Jan 18, 2006
Last updated
Dec 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Authorized official

Name
Dr. Deeann Nason, DCNPI 1194924167
Title
Chiropractic President
Phone
(818) 247-4766

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 20329 CA Primary

Addresses

Primary practice location

3542 Hollydale Dr
Los Angeles, CA 90039-2117

Mailing address

5612 Spa Dr
Huntington Beach, CA 92647-2025
Phone (323) 513-2983

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110815000719 CA Part B Supplier - Clinic/Group Practice 3678742376 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

620 N Brand Blvd
Ste 400
Glendale, CA 91203
Phone (818) 247-4766

Practitioners & affiliated clinicians

Practitioners 2

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": "1137542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1174503072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5612 SPA DR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926472025",
            "telephone_number": "323-513-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3542 HOLLYDALE DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900392117",
            "telephone_number": "818-247-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH GLEN CHIROPRACTIC, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-18",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "NASON",
        "authorized_official_first_name": "DEEANN",
        "authorized_official_title_or_position": "CHIROPRACTIC PRESIDENT",
        "authorized_official_telephone_number": "818-247-4766",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "20329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.