Abella-Desuyo Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

ABELLA-DESUYO CHIROPRACTIC

Doing business as

Pacific Coast Kinesiology Center

Practice address

30270 Rancho Viejo Rd Ste E
San Juan Capistrano, CA 92675-1556

Phone

(949) 716-3930

NPI assigned

Oct 12, 2019

Last updated

Sep 18, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeanna Lynn Abella-Desuyo, DCNPI 1477075463

Title

Ceo/Owner

Phone

(209) 559-4498

Specialties & licenses 1

Addresses

Other names 1

• Pacific Coast Kinesiology Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeanna Lynn Abella-Desuyo, D.C.

  • Chiropractor
  • San Juan Capistrano, CA
  • NPI 1477075463
  Medicare reassignment NPD Authorized official
• Tracy Megumi Wheelwright, DC

  • Chiropractor
  • Westminster, CA
  • NPI 1558066720
  Medicare reassignment NPD
• Paul Joseph Garcia, DC

  • Chiropractor
  • Meridian, ID
  • NPI 1235335142
  NPD
• Brian Gregory Boone, D.P.T.

  • Physical Therapist
  • Mission Viejo, CA
  • NPI 1023320744
  NPD (past)

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

{
    "created_epoch": "1570838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600387200000",
    "number": "1265074140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30270 RANCHO VIEJO RD STE E",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751556",
            "telephone_number": "949-716-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30270 RANCHO VIEJO RD STE E",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751556",
            "telephone_number": "949-716-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABELLA-DESUYO CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-12",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A",
        "authorized_official_last_name": "ABELLA-DESUYO",
        "authorized_official_first_name": "JEANNA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "209-559-4498",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Coast Kinesiology Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.