Individual provider Active NPI

Tyler Poland, D.C.

  • Chiropractor
  • Davis, CA
National Provider Identifier
1194258293
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
33826 Issued in CA
Practice address
635 Anderson Rd
Ste 14
Davis, CA 95616-3505
Phone
(530) 400-8390
NPI assigned
Apr 5, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 33826 CA Primary

Addresses

Primary practice location

635 Anderson Rd
Ste 14
Davis, CA 95616-3505

Mailing address

2014 Klee PL
Davis, CA 95618-7617
Phone (530) 400-8390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1194258293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 KLEE PL",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956187617",
            "telephone_number": "530-400-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 ANDERSON RD",
            "address_2": "STE 14",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956163505",
            "telephone_number": "530-400-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLAND",
        "first_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-05",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; 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.