Organization Active NPI

Peninsula Wellness Centre

  • Chiropractor
  • Mountain View, CA
National Provider Identifier
1184246696
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PENINSULA WELLNESS CENTRE
Practice address
2425 Callifornia St Ste E
Mountain View, CA 94040
Phone
(650) 961-2429
Fax
(650) 969-1107
NPI assigned
May 7, 2020
Last updated
May 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2020

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

Authorized official

Name
Dr. Johnny Van Duong, DC
Title
Owner
Phone
(909) 961-2429

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

2425 Callifornia St Ste E
Mountain View, CA 94040

Mailing address

2425 California St Ste E
Mountain View, CA 94040-1462
Phone (650) 961-2429

Other names 1

  • Landis Management Services Other name

National Provider Directory

National Provider Directory

Locations

2425 California St
Ste E
Mountain View, CA 94040
Phone (650) 961-2429

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": "1588809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588809600000",
    "number": "1184246696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 CALIFORNIA ST STE E",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940401462",
            "telephone_number": "650-961-2429",
            "fax_number": "650-969-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 CALLIFORNIA ST STE E",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "94040",
            "telephone_number": "650-961-2429",
            "fax_number": "650-969-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA WELLNESS CENTRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-07",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A",
        "authorized_official_last_name": "DUONG",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-961-2429",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Landis Management Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mountain View, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.