Individual provider Active NPI

Gilbert Youdeem, DC

  • Chiropractor
  • Cypress, CA
National Provider Identifier
1326070830
Registry record updated Oct 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC24875 Issued in CA
Practice address
9919 Walker St
Cypress, CA 90630-3827
Phone
(714) 527-7463
Fax
(714) 527-8962
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC24875 CA Primary
Sports Physician Chiropractor 111NS0005X DC24875 CA

Addresses

Primary practice location

9919 Walker St
Cypress, CA 90630-3827

Mailing address

9919 Walker St
Cypress, CA 90630-3827
Phone (714) 527-7463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041103000577 CA Practitioner - Chiropractic 0446212229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9922 Walker St
Suite G
Cypress, CA 90630-3097
Phone (714) 527-7463

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24875CAMDMarriage & Family Therapist
DC24875CAMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Youdeem Chiropractic Corporation CurrentSince Sep 1, 2005 Accepting new patients

Locations

9919 Walker St
Cypress, CA 90630
Phone (714) 527-7463

9922 Walker St
Ste G
Cypress, CA 90630
Phone (714) 220-0290

4021 Orange Ave
Cypress, CA 90630
Phone (562) 283-8223

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254700800000",
    "number": "1326070830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9919 WALKER ST",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906303827",
            "telephone_number": "714-527-7463",
            "fax_number": "714-527-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9919 WALKER ST",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906303827",
            "telephone_number": "714-527-7463",
            "fax_number": "714-527-8962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUDEEM",
        "first_name": "GILBERT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2009-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC24875",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC24875",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.