Dr. Shaun Matsumoto Alta Chiropractic and Wellness Center, Inc.
Organization Active NPI Chiropractor · Dinuba, CA
NPI 1255820247 · NPPES record last updated Feb 25, 2024
Key facts
- NPI
- 1255820247
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 30341 (CA)
- Legal business name
- DR. SHAUN MATSUMOTO ALTA CHIROPRACTIC AND WELLNESS CENTER, INC.
- Practice address
- 1171 N Alta Ave
Dinuba, CA 93618-9311 - Phone
- (559) 315-5070
- Fax
- (559) 315-5726
- NPI assigned
- May 4, 2018
- Organization subpart
- No
Authorized official
- Name
- Dr. Shaun Matsumoto, DC
- Title
- Chiropractor
- Phone
- (559) 315-5070
Practitioners 1
-
Shaun Robert Matsumoto, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181112000664 | CA | Part B Supplier - Clinic/Group Practice | 6002160058 |
Receives reassigned benefits from 1 practitioner Practice locations: Dinuba, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 30341 | CA | Yes |
Addresses
Primary practice location
1171 N Alta Ave
Dinuba, CA 93618-9311
Mailing address
1171 N Alta Ave
Dinuba, CA 93618-9311
Phone (559) 315-5070
Other names
- Alta Chiropractic and Wellness Center
Other providers in Dinuba, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.