Individual provider Active NPI

Harold Rey Gubernick, DC

  • Chiropractor
  • Costa Mesa, CA
National Provider Identifier
1346398765
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC20871 Issued in CA
Practice address
3011 Harbor Blvd
Costa Mesa, CA 92626-2504
Phone
(951) 235-7121
Fax
(951) 755-0395
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC20871 CA Primary

Addresses

Primary practice location

3011 Harbor Blvd
Costa Mesa, CA 92626-2504

Mailing address

3011 Harbor Blvd
Costa Mesa, CA 92626-2504
Phone (951) 235-7121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DC20871CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Health Center Chiropractor Past Accepting new patients
Orange Coast Medical Assoc Past Accepting new patients

Organizations & group practices 2

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346398765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 HARBOR BLVD",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262504",
            "telephone_number": "951-235-7121",
            "fax_number": "951-755-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 HARBOR BLVD",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262504",
            "telephone_number": "951-235-7121",
            "fax_number": "951-755-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUBERNICK",
        "first_name": "HAROLD",
        "middle_name": "REY",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC20871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.