Giancarlo Licata, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

30840 Issued in CA

Practice address

131 N El Molino Ave Ste 150
Pasadena, CA 91101-4149

Phone

(626) 564-8900

Fax

(626) 564-8902

NPI assigned

Feb 26, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509667200000",
    "number": "1285803080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 N EL MOLINO AVE STE 150",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911014149",
            "telephone_number": "626-564-8900",
            "fax_number": "626-564-8902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 N EL MOLINO AVE STE 150",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911014149",
            "telephone_number": "626-564-8900",
            "fax_number": "626-564-8902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Wheeler Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "CA",
            "postal_code": "910063240",
            "country_code": "US",
            "telephone_number": "626-446-3400",
            "fax_number": "626-446-3404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICATA",
        "first_name": "GIANCARLO",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-26",
        "last_updated": "2017-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "30840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2017; 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.