Individual provider Active NPI

David Augie Pommerenck Jr., D.C.

  • Chiropractor
  • Lomita, CA
National Provider Identifier
1174546626
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
16484 Issued in CA
Practice address
2049 Pacific Coast Hwy
Suite 101
Lomita, CA 90717-2632
Phone
(310) 530-7335
Fax
(310) 530-3681
NPI assigned
Jul 25, 2006
Last updated
Feb 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 16484 CA Primary

Addresses

Primary practice location

2049 Pacific Coast Hwy
Suite 101
Lomita, CA 90717-2632

Mailing address

25095 Jefferson Ave Ste 203
Murrieta, CA 92562-9107
Phone (951) 894-5006

Other identifiers 1

IdentifierTypeStateIssuer
33-0165618OtherCATAX ID NO.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250519003584 CA Practitioner - Chiropractic 6103961065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
University of Pasadena College of Chiropractic, 1978
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

25095 Jefferson Ave
Suite 203
Murrieta, CA 92562-9107
Phone (951) 894-5006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pommerenck Chiropractic Corporation Chiropractor CurrentSince Mar 15, 2025 Accepting new patients
Adam Chiropractic & Wellness Center Inc. Chiropractor PastSince Aug 4, 2019 Accepting new patients

Locations

25095 Jefferson Ave
Ste 203
Murrieta, CA 92562
Phone (951) 677-5440

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1174546626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25095 JEFFERSON AVE STE 203",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629107",
            "telephone_number": "951-894-5006",
            "fax_number": "951-698-8749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2049 PACIFIC COAST HWY",
            "address_2": "SUITE 101",
            "city": "LOMITA",
            "state": "CA",
            "postal_code": "907172632",
            "telephone_number": "310-530-7335",
            "fax_number": "310-530-3681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMMERENCK",
        "first_name": "DAVID",
        "middle_name": "AUGIE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "16484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID NO.",
            "identifier": "33-0165618",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lomita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.