Organization Active NPI

Symmetry Health Inc

Doing business as Michael C. Wilson, DC

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1174838460
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-31747 Issued in CA
Legal business name
SYMMETRY HEALTH INC
Doing business as
Michael C. Wilson, DC
Practice address
4432 Ingraham St
San Diego, CA 92109-4404
Phone
(858) 270-2225
Fax
(858) 270-6898
NPI assigned
Aug 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Authorized official

Name
Michael Cole Wilson X, D.C.NPI 1487968111
Title
Owner
Phone
(858) 270-2225

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC-31747 CA Primary

Addresses

Primary practice location

4432 Ingraham St
San Diego, CA 92109-4404

Mailing address

4432 Ingraham St
San Diego, CA 92109-4404
Phone (858) 270-2225

Other names 1

  • Michael C. Wilson, DC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150420001422 CA Part B Supplier - Clinic/Group Practice 7416275607 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

2204 Garnet Ave
Ste 201
San Diego, CA 92109
Phone (858) 270-2225

4432 Ingraham St
San Diego, CA 92109
Phone (858) 270-2225

Practitioners & affiliated clinicians

Practitioners 2

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": "1281484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1174838460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4432 INGRAHAM ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921094404",
            "telephone_number": "858-270-2225",
            "fax_number": "858-270-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4432 INGRAHAM ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921094404",
            "telephone_number": "858-270-2225",
            "fax_number": "858-270-6898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYMMETRY HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-11",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "COLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-270-2225",
        "authorized_official_name_suffix": "X",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-31747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael C. Wilson, DC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.