Lifestyle Chiropractic & Sports Performance, a Camacho Corp.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

LIFESTYLE CHIROPRACTIC & SPORTS PERFORMANCE, A CAMACHO CORP.

Practice address

2079 S Atlantic Blvd Ste D
Monterey Park, CA 91754-6368

Phone

(626) 602-6138

NPI assigned

May 9, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Everardo Camacho, DCNPI 1659061265

Title

Owner

Phone

(626) 602-6138

Specialties & licenses 1

Addresses

Other names 1

• Lifestyle Chiropractic & Sports Performance Other name

Locations

Practitioners 1

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

• Everardo Camacho, DC

  • Chiropractor
  • Simi Valley, CA
  • NPI 1659061265
  NPD Authorized official

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1306536909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E GRANADA CT",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917643219",
            "telephone_number": "626-602-6138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2079 S ATLANTIC BLVD STE D",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917546368",
            "telephone_number": "626-602-6138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE CHIROPRACTIC & SPORTS PERFORMANCE, A CAMACHO CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "CAMACHO",
        "authorized_official_first_name": "EVERARDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-602-6138",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifestyle Chiropractic & Sports Performance",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Chiropractor in Monterey Park, CA
• Providers in Monterey Park, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.