Wine Country Chiropractic Mark S. Banasiak DC Inc. a Professional Corp

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC23625 Issued in CA

Legal business name

WINE COUNTRY CHIROPRACTIC MARK S. BANASIAK DC INC. A PROFESSIONAL CORP

Practice address

27555 Ynez Rd Ste 350
Temecula, CA 92591-4688

Phone

(951) 587-2225

Fax

(951) 365-0027

NPI assigned

Jul 7, 2010

Organization subpart

No

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

Authorized official

Name

Mark S. Banasiak, D.C.NPI 1033299359

Title

Doctor of Chiropractic

Phone

(951) 587-2225

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Mark S. Banasiak, D.C.

  • Chiropractor
  • Temecula, CA
  • NPI 1033299359
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1316259377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29377 RANCHO CALIFORNIA RD",
            "address_2": "SUITE# 106",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925915206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27555 YNEZ RD STE 350",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925914688",
            "telephone_number": "951-587-2225",
            "fax_number": "951-365-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINE COUNTRY CHIROPRACTIC MARK S. BANASIAK DC INC. A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-07",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "BANASIAK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "951-587-2225",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC23625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ63647Y",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul James Wilson, O.D.
• Taniesha Wilson
• Tori Bianca Wilson
• Kenneth Wimmer
• Dylin Winchester
• Denise Michele Wingate, M.A., MFT
• Alan Marc Winkelstein, O.D.
• Danielle Marie Winkler, M.D.
• Brian Jeffrey Winter, M.D.
• Sandra Winter

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.