Abella-Desuyo Chiropractic – Chiropractor

Key facts

NPI: 1265074140
Entity type: Organization (NPI type 2)
Primary specialty: Chiropractor 111N00000X
Legal business name: ABELLA-DESUYO CHIROPRACTIC
Practice address: 30270 Rancho Viejo Rd Ste E
San Juan Capistrano, CA 92675-1556
Phone: (949) 716-3930
NPI assigned: Oct 12, 2019
Organization subpart: No

Authorized official

Name: Jeanna Lynn Abella-Desuyo, DC NPI 1477075463
Title: Ceo/Owner
Phone: (209) 559-4498

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 4

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

Jeanna Lynn Abella-Desuyo, D.C. Chiropractor · San Juan Capistrano, CA · NPI 1477075463

Medicare reassignment NPD Authorized official CA · CHIROPRACTOR
Tracy Megumi Wheelwright, DC Chiropractor · Westminster, CA · NPI 1558066720

Medicare reassignment NPD CA · CHIROPRACTOR
Paul Joseph Garcia, DC Chiropractor · Meridian, ID · NPI 1235335142

NPD CHIROPRACTOR
Brian Gregory Boone, D.P.T. Physical Therapist · Mission Viejo, CA · NPI 1023320744

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20200423001545	CA	Part B Supplier - Clinic/Group Practice	2860822301	Receives reassigned benefits from 2 practitioners Practice locations: San Juan Capistrano, CA

National Provider Directory

Locations

30270 Rancho Viejo Rd
Ste E
San Juan Capistrano, CA 92675
Phone (209) 559-4498

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor Group: 193400000X SINGLE SPECIALTY GROUP	111N00000X			Yes

Addresses

Primary practice location

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

Mailing address

30270 Rancho Viejo Rd Ste E
San Juan Capistrano, CA 92675-1556
Phone (949) 716-3930

Other names

Pacific Coast Kinesiology Center Doing business as

Other providers in San Juan Capistrano, CA

All providers in San Juan Capistrano, CA · Chiropractor in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2020. 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.

Verify at the official NPI Registry.