Organization Active NPI

Wellness of SD LLC

  • Sports Physician Chiropractor
  • San Diego, CA
National Provider Identifier
1275265134
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
Legal business name
WELLNESS OF SD LLC
Practice address
5350 Riley St
San Diego, CA 92110-2621
Phone
(805) 727-1234
NPI assigned
Jun 29, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Authorized official

Name
Vincente T Ortiz Jr.
Title
Owner
Phone
(805) 727-1234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NS0005X Primary

Addresses

Primary practice location

5350 Riley St
San Diego, CA 92110-2621

Mailing address

4150 Albatross Dr
San Diego, CA 92103-1905
Phone (805) 727-1234

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658448000000",
    "number": "1275265134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 ALBATROSS DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921031905",
            "telephone_number": "805-727-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 RILEY ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102621",
            "telephone_number": "805-727-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS OF SD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "VINCENTE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-727-1234",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 22, 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.