Individual provider Active NPI

Charles Vincent Sciolino, D.C.

  • Chiropractor
  • Brea, CA
National Provider Identifier
1235288499
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
24048 Issued in CA
Practice address
255 W Central Ave
Suite 102
Brea, CA 92821-3373
Phone
(714) 255-7062
Fax
(714) 255-8066
NPI assigned
Jan 9, 2007
Sex
Male
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 24048 CA Primary

Addresses

Primary practice location

255 W Central Ave
Suite 102
Brea, CA 92821-3373

Mailing address

255 W Central Ave
Suite 102
Brea, CA 92821-3373
Phone (714) 255-7062

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040217000278 CA Practitioner - Chiropractic 5395630636 Practice locations: Brea, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

451 W Lambert Rd
Suite 200
Brea, CA 92821-3905
Phone (714) 255-7062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24048CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235288499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W CENTRAL AVE",
            "address_2": "SUITE 102",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213373",
            "telephone_number": "714-255-7062",
            "fax_number": "714-255-8066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W CENTRAL AVE",
            "address_2": "SUITE 102",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213373",
            "telephone_number": "714-255-7062",
            "fax_number": "714-255-8066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCIOLINO",
        "first_name": "CHARLES",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "24048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, 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.