Phillip Dietrich, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

11891 Issued in CA

Practice address

363 El Camino Real
Suite 105
South San Francisco, CA 94080-5980

Phone

(650) 291-0709

NPI assigned

Mar 6, 2007

Last updated

Jan 11, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Los Angeles, 1977

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1255461695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 EL CAMINO REAL",
            "address_2": "SUITE 105",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 EL CAMINO REAL",
            "address_2": "SUITE 105",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805980",
            "telephone_number": "650-291-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICH",
        "first_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "11891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Desimini, D.M.D
• Usha Desiraju
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• Ronald R Desmarais, DC
• Gabriela Diaz
• Julianna Tyler Diggs
• Eric P. Dilda, MD
• Vincent J. Dilella, MD
• Eufemia Encinares Dimacali
• Kamilia Halwani Dimitri

• Chiropractor in South San Francisco, CA
• Providers in South San Francisco, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; 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.