C.W. Klishevich

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC21026 Issued in CA

Legal business name

C.W. KLISHEVICH

Practice address

4560 Admiralty Way
Ste 302
Marina del Rey, CA 90292-5423

Phone

(310) 348-0500

NPI assigned

Apr 23, 2007

Organization subpart

No

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

Authorized official

Name

Steven Garrett

Title

Billing Manager

Phone

(310) 348-0500

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cergei Walter Klishevich, D.C.

  • Chiropractor
  • Marina del Rey, CA
  • NPI 1508904244
  NPD (past)

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245458272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 ADMIRALTY WAY",
            "address_2": "STE 302",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "90292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 ADMIRALTY WAY",
            "address_2": "STE 302",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925423",
            "telephone_number": "310-348-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C.W. KLISHEVICH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GARRETT",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "310-348-0500"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC21026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tygr Lynne Burnett, DPT
• Aaron Burrola
• California Coastal Care
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• Calloway Health Care, LLC

• Chiropractor in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.