Active NPI
Daniel W Gambino, DC
- Chiropractor
- San Diego, CA
National Provider Identifier
1265599765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- WV741
- Practice address
- 6030 Santo Rd Ste D
San Diego, CA 92124-1196 - Phone
- (858) 541-0505
- NPI assigned
- Jan 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | WV741 | WV | Primary |
Addresses
Primary practice location
6030 Santo Rd Ste D
San Diego, CA 92124-1196
Mailing address
217 N 27TH St
Clarksburg, WV 26301-2310
Phone (304) 623-7800
Other practice location 1
217 North 27th Street
Clarksburg, WV 26301-2310
Phone (304) 623-7800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001706140 | Other | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31087 | CA | MD | Clinical Psychologist |
| WV741 | WV | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life University, Inc | Chiropractor | Current | Accepting new patients |
| Life University Inc | Chiropractor | Current | Accepting new patients |
| Bodzin Chiropractic Professional Corporation | Chiropractor | Past | Accepting new patients |
Locations
1415 Barclay Cir SE
Marietta, GA 30060
Phone (770) 426-2786
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- San Juan, PR
- NPI 1508580978
-
- Chiropractor
- San Diego, CA
- NPI 1710005541
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1265599765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "217 N 27TH ST",
"city": "CLARKSBURG",
"state": "WV",
"postal_code": "263012310",
"telephone_number": "304-623-7800",
"fax_number": "304-623-0706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6030 SANTO RD STE D",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921241196",
"telephone_number": "858-541-0505"
}
],
"practiceLocations": [
{
"address_1": "217 North 27th Street",
"address_purpose": "LOCATION",
"city": "Clarksburg",
"state": "WV",
"postal_code": "263012310",
"country_code": "US",
"telephone_number": "304-623-7800",
"fax_number": "304-623-0706",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GAMBINO",
"first_name": "DANIEL",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WV",
"license": "WV741",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "001706140",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.