Organization Active NPI

Salem Chiropractic PC

  • Chiropractor
  • Tustin, CA
National Provider Identifier
1265612741
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC17986 Issued in CA
Legal business name
SALEM CHIROPRACTIC PC
Practice address
13891 Newport Ave Ste 290
Tustin, CA 92780-7835
Phone
(714) 832-4010
Fax
(714) 515-5969
NPI assigned
Nov 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Authorized official

Name
Mr. Gregory J Salem, D.C.NPI 1710072632
Title
Owner
Phone
(714) 832-4010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC17986 CA Primary

Addresses

Primary practice location

13891 Newport Ave Ste 290
Tustin, CA 92780-7835

Mailing address

13882 Newport Ave
Suite B
Tustin, CA 92780-4666
Phone (714) 832-4010

Other identifiers 1

IdentifierTypeStateIssuer
DC17986OtherCAPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090122000003 CA Part B Supplier - Clinic/Group Practice 4082778931 Receives reassigned benefits from 1 practitioner
Practice locations: Tustin, CA

National Provider Directory

National Provider Directory

Locations

13891 Newport Ave
Ste 290
Tustin, CA 92780
Phone (714) 832-4010

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661472000000",
    "number": "1265612741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13882 NEWPORT AVE",
            "address_2": "SUITE B",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804666",
            "telephone_number": "714-832-4010",
            "fax_number": "714-832-2423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13891 NEWPORT AVE STE 290",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807835",
            "telephone_number": "714-832-4010",
            "fax_number": "714-515-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEM CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A",
        "authorized_official_last_name": "SALEM",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-832-4010",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC17986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "DC17986",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; 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.