Active NPI
Larry Maddalena, D.C.
- Chiropractor
- Ventura, CA
National Provider Identifier
1225031511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC24826
- Practice address
- 1732 Palma Dr
Ste 104
Ventura, CA 93003-5796 - Phone
- (805) 642-6565
- Fax
- (805) 642-6524
- NPI assigned
- May 31, 2005
- Sex
- Male
- Sole proprietor
- No
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 | DC24826 | CA | Primary |
Addresses
Primary practice location
1732 Palma Dr
Ste 104
Ventura, CA 93003-5796
Mailing address
1732 Palma Dr
Ste 104
Ventura, CA 93003-5796
Phone (805) 642-6565
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC0248260 | Medicaid | CA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC24826 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189123200000",
"number": "1225031511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1732 PALMA DR",
"address_2": "STE 104",
"city": "VENTURA",
"state": "CA",
"postal_code": "930035796",
"telephone_number": "805-642-6565",
"fax_number": "805-642-6524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1732 PALMA DR",
"address_2": "STE 104",
"city": "VENTURA",
"state": "CA",
"postal_code": "930035796",
"telephone_number": "805-642-6565",
"fax_number": "805-642-6524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADDALENA",
"first_name": "LARRY",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-31",
"last_updated": "2007-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC24826",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DC0248260",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ventura, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.