Active NPI
Mara Bush, DC
- Chiropractor
- La Jolla, CA
National Provider Identifier
1174933105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 11558
- Practice address
- 7596 Eads Ave
Suite 100
La Jolla, CA 92037-4851 - Phone
- (858) 456-2663
- Fax
- (858) 456-9925
- NPI assigned
- Apr 29, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 11558 | CA | Primary |
Addresses
Primary practice location
7596 Eads Ave
Suite 100
La Jolla, CA 92037-4851
Mailing address
9066 Palomino Ridge Dr
Lakeside, CA 92040-5806
Phone (619) 938-1024
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140712000157 | CA | Practitioner - Chiropractic | 0042435778 | Practice locations: El Cajon, CA; Santee, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1985 N Marshall Ave
Suite 110
El Cajon, CA 92020-1111
1985 N Marshall Ave
Suite 110
El Cajon, CA 92020-1192
Phone (619) 971-4576
9225 Carlton Hills Blvd
Santee, CA 92071-7902
Phone (619) 258-9732
9225 Carlton Hills Blvd
Suite 18
Santee, CA 92071-2980
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11558 | CA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398729600000",
"number": "1174933105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9066 PALOMINO RIDGE DR",
"city": "LAKESIDE",
"state": "CA",
"postal_code": "920405806",
"telephone_number": "619-938-1024",
"fax_number": "619-258-9738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7596 EADS AVE",
"address_2": "SUITE 100",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920374851",
"telephone_number": "858-456-2663",
"fax_number": "858-456-9925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSH",
"first_name": "MARA",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-29",
"last_updated": "2014-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "11558",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; 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.