Individual provider Active NPI

Christopher Guistolise, D.C.

  • Chiropractor
  • Tracy, CA
National Provider Identifier
1184762072
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 19670 Issued in CA
Practice address
4600 S Tracy Blvd
Suite 116
Tracy, CA 95377-8105
Phone
(209) 832-9700
NPI assigned
Feb 2, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 19670 CA Primary

Addresses

Primary practice location

4600 S Tracy Blvd
Suite 116
Tracy, CA 95377-8105

Mailing address

4600 S Tracy Blvd
Suite 116
Tracy, CA 95377-8105
Phone (209) 832-9700

Other identifiers 1

IdentifierTypeStateIssuer
DC0196700OtherCABLUE SHIELD PROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051109001099 CA Practitioner - Chiropractic 2264450006 Practice locations: Tracy, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4600 S Tracy Blvd
Tracy, CA 95377-8105
Phone (209) 832-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
19670CAMDClinical Social Worker
DC 19670CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184762072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 S TRACY BLVD",
            "address_2": "SUITE 116",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953778105",
            "telephone_number": "209-832-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 S TRACY BLVD",
            "address_2": "SUITE 116",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953778105",
            "telephone_number": "209-832-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUISTOLISE",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 19670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER #",
            "identifier": "DC0196700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

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.

Verify at the official NPI Registry.