Active NPI
Mark Lewis Vinick, D.C.
- Chiropractor
- Redondo Beach, CA
National Provider Identifier
1326268269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC18993
- Practice address
- 1860 S Elena Ave
Suite a
Redondo Beach, CA 90277-5706 - Phone
- (310) 375-4325
- Fax
- (310) 373-9225
- NPI assigned
- Apr 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC18993 | CA | Primary |
Addresses
Primary practice location
1860 S Elena Ave
Suite a
Redondo Beach, CA 90277-5706
Mailing address
1860 S Elena Ave
Suite a
Redondo Beach, CA 90277-5706
Phone (310) 375-4325
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090302000664 | CA | Practitioner - Chiropractic | 6507922465 | Practice locations: Redondo Beach, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Los Angeles College of Chiropractic, 1987
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1860 S Elena Ave
Suite a
Redondo Beach, CA 90277-5739
Phone (310) 375-4325
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC18993 | CA | MD | Chiropractor |
| 18993 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326240000000",
"number": "1326268269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1860 S ELENA AVE",
"address_2": "SUITE A",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902775706",
"telephone_number": "310-375-4325",
"fax_number": "310-373-9225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1860 S ELENA AVE",
"address_2": "SUITE A",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902775706",
"telephone_number": "310-375-4325",
"fax_number": "310-373-9225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINICK",
"first_name": "MARK",
"middle_name": "LEWIS",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-25",
"last_updated": "2012-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC18993",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redondo Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.