Khaleed Samuels, D.C. C.C.S.P

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

DC33008 Issued in CA

Practice address

1423 W 8TH St
San Pedro, CA 90732-3803

Phone

(310) 684-1807

Fax

(310) 684-1607

NPI assigned

Jan 22, 2015

Last updated

Oct 5, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Samuels Chiropractic Health Corporation

  • Sports Physician Chiropractor
  • San Pedro, CA
  • NPI 1083389878
  NPD Authorized official
• Axiom Health Physical Medicine Inc

  • Physical Medicine & Rehabilitation Physician
  • Venice, CA
  • NPI 1811411002

  Single Specialty

  NPD (past)
• Rutambhar Patel D.C. a Chiropractic Corporation

  dba Axiom Health

  • Chiropractor
  • Venice, CA
  • NPI 1619298304
  NPD (past)

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1265821672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28000 S WESTERN AVE UNIT 227",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907321204",
            "telephone_number": "310-684-1807",
            "fax_number": "310-684-1607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 W 8TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323803",
            "telephone_number": "310-684-1807",
            "fax_number": "310-684-1607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1911 S Catalina Ave",
            "address_purpose": "LOCATION",
            "city": "Redondo Beach",
            "state": "CA",
            "postal_code": "902775515",
            "country_code": "US",
            "telephone_number": "424-304-2040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "KHALEED",
        "name_prefix": "Dr.",
        "credential": "D.C.  C.C.S.P",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-22",
        "last_updated": "2022-10-05",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC33008",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC33008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dafne Ileana Salgado Jovel
• Ma Christina Salgado-Cortez
• Amber Rochelle Salvador
• Samuel K Wirtschafter MD Inc
• Samuels Chiropractic Health Corporation
• San Miguel Urgent Care San Pedro
• San Pedro Acupuncture Corporation (San Pedro Acupuncture Health Center)
• San Pedro Convalescent Home, Inc. (Los Palos Convalescent Hospital)
• San Pedro Dental
• San Pedro Eye Medical Group, Inc a Professional Medical Corporation (San Pedro Eye Care)

• Sports Physician Chiropractor in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Sports Physician Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.

Verify at the official NPI Registry.