Active NPI
Olman Mata, DC
- Chiropractor
- Covina, CA
National Provider Identifier
1174688253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 22763
- Practice address
- 461 W Badillo St
Covina, CA 91723-1834 - Phone
- (626) 966-4469
- Fax
- (626) 915-8929
- NPI assigned
- Dec 27, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 22763 | CA | Primary |
Addresses
Primary practice location
461 W Badillo St
Covina, CA 91723-1834
Mailing address
461 W Badillo St
Covina, CA 91723
Phone (626) 966-4469
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Los Angeles College of Chiropractic, 1991
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
461 W Badillo St
Covina, CA 91723-1834
Phone (626) 966-4469
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174688253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "461 W BADILLO ST",
"city": "COVINA",
"state": "CA",
"postal_code": "91723",
"telephone_number": "626-966-4469",
"fax_number": "626-915-8929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "461 W BADILLO ST",
"city": "COVINA",
"state": "CA",
"postal_code": "917231834",
"telephone_number": "626-966-4469",
"fax_number": "626-915-8929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATA",
"first_name": "OLMAN",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "22763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covina, CA
- Masonic Homes of California (Masonic Homes of California - Covina)
- Masonic Homes of California
- Masonic Homes of California (Citrus Heights Health Center)
- Mata Chiropractic, Inc. (Covina Chiropractic)
- Nelly Zulema Mata Navarro
- Henry Georginio Mateo
- Elizabeth Mathew, AGACNP DNP
- Kristina Mathews
- Matrix Document Imaging
- Maryon Matsuda, PH.D, CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.